Sex differences in completion of a 12-month cardiac rehabilitation programme: an analysis of 5922 women and men

BACKGROUND: The reasons for greater premature withdrawal from cardiac rehabilitation programmes (CRP) in women compared with men and differences in baseline predictors of withdrawal have not been extensively studied. METHODS: Reasons for withdrawal from a 12-month CRP in 1089 women and 4833 men were ascertained by interview. Regression analysis was used to determine demographic and baseline medical conditions that predicted noncompletion. RESULTS: Noncompletion was higher in women than men (35 vs. 29%, P<0.001), however, multivariate regression revealed that sex was not the main driver of withdrawal but rather, other factors common to women at entry to CR could predict noncompletion (i.e. not being married, being obese, lower peak oxygen uptake, not having earlier coronary artery bypass graft surgery, being on antidepressant medication and not on lipid lowering or beta-blockade medication). By interview, a greater proportion of women than men withdrew for medical issues (P<0.001), specifically musculoskeletal conditions (P=0.002) and multiple medical problems (P=0.02). A greater proportion of women withdrew for transportation (P<0.001) and family issues (P=0.009), whereas work issues affected men more than women (P=0.009), as did lack of interest (P=0.009). Women were more likely to withdraw than men regardless of age (P<0.05). CONCLUSION: Women were significantly more likely to withdraw from CRP than men because of greater medical problems, specifically musculoskeletal and multiple medical reasons. Lack of interest and work obligations were greater barriers for men while transportation and family obligations more often affected women. Difference in withdrawal can be explained by the profile of women rather than by sex independently.