Key result
Cardiac rehabilitation attendance reaches ~53%, driven primarily by individual patient factors.
Why the study?
Attendance rates and determinants for cardiac, pulmonary, and ICU rehabilitation/recovery programs after acute illness hospitalization were not well characterized across program types.
What are the attendance rates and factors influencing attendance in cardiac, pulmonary, and ICU rehabilitation/recovery programs?
Meta-Analysis (n=4,779,012)
What are the attendance rates and factors influencing attendance in cardiac, pulmonary, and ICU rehabilitation/recovery programs?
Attendance rates across cardiac, pulmonary, and ICU rehabilitation programs are comparable (53-61%), with individual factors such as transportation, work conflicts, and comorbidities acting as primary barriers.
Suboptimal attendance signals need for barrier-targeted strategies in practice; extends single-program data with pooled estimates across rehabilitation types.
Background Cardiac, pulmonary, and intensive care unit (ICU) rehabilitation/recovery programs are health promotion interventions designed to improve physical recovery, psychological well-being, and quality of life after acute illness while reducing the risk of adverse events. Objective Identify the difference in attendance rates for patients invited to a cardiac rehabilitation, pulmonary rehabilitation, or ICU recovery program and factors influencing attendance. Methods We conducted a systematic review and meta-analysis by searching PubMed, EMBASE, CINAHL, Web of Science, and manual reference lists from inception to June 3, 2024. We included studies reporting patient attendance rates in eligible programs following acute illness hospitalization. Two team members independently screened articles and extracted data, with a third member reviewing and achieving consensus when necessary. Our main outcomes focused on the proportion of attendance in eligible programs among patients referred. Results Of 3,446 studies screened, 179 studies ( N = 4,779,012 patients) were included across cardiac rehabilitation ( n = 153 studies), pulmonary rehabilitation ( n = 11 studies), and ICU recovery ( n = 15 studies) programs. Pooled attendance rates were 53 % (95 % CI: 48-57 %) for cardiac rehabilitation, 56 % (95 % CI: 42-70 %) for pulmonary rehabilitation, and 61 % (95 % CI: 51-70 %) for ICU recovery programs. Significant attendance heterogeneity was present (cardiac I 2 =100 %, p < 0.001; pulmonary I 2 =100 %, p < 0.001; ICU I 2 =94 %, p < 0.01). Barriers to attendance included transportation, distance, work conflicts, and patient factors (e.g., comorbidities, older age). Facilitators included male gender, younger age, higher education, income, provider recommendations, and flexible scheduling. Individual factors represented the primary domain affecting attendance. Conclusions The results indicate comparable attendance rates and factors shaping attendance across acute illness rehabilitation/recovery programs, with ICU recovery programs being the most well-attended on average.
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Boehm et al. (2024) conducted a meta-analysis in Acute illness hospitalization requiring rehabilitation (n=4,779,012). Cardiac, pulmonary, and ICU rehabilitation/recovery programs was evaluated on Proportion of attendance in eligible programs among patients referred. Pooled attendance rates were 53% for cardiac, 56% for pulmonary, and 61% for ICU recovery programs, with individual factors representing the primary domain affecting attendance.
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