Key result
Phase II cardiac rehabilitation yields ~90% disease knowledge scores, correlating with better diet and medication adherence.
Why the study?
This study aimed to multinationally characterize CVD management knowledge following cardiac rehabilitation across regions, country income classifications, and patient characteristics, and to evaluate its associations with CR utilization, delivery setting, and corresponding health markers.
Does phase II outpatient cardiac rehabilitation improve patient-reported cardiovascular disease management knowledge and associated health markers in a multinational cohort of cardiac patients?
Observational (n=4,309)
Yes
Does phase II outpatient cardiac rehabilitation improve patient-reported cardiovascular disease management knowledge and associated health markers in a multinational cohort of cardiac patients?
Multinational participants in outpatient cardiac rehabilitation report high post-program disease management knowledge, which is positively associated with completion of rehabilitation and healthier behaviors such as medication adherence and nutrition.
High post-CR knowledge may aid adherence behaviors; extends single-center data multinationally yet leaves causal effects open.
Objectives To multinationally investigate: (1) CVD management knowledge following CR, including variations by region, country income classification, as well as patient sociodemographic and clinical characteristics; (2) the association of post-CR knowledge with the number of CR sessions completed and setting of CR delivery; and (3) whether domain-specific knowledge post-CR is associated with corresponding health markers. Methods Secondary analysis of the International Council of Cardiovascular Prevention and Rehabilitation’s International Cardiac Rehabilitation Registry (ICRR) data to December 2024 was conducted for this prospective observational study. Eligible patients were those receiving phase II outpatient CR, with pre-program assessment completed ≥6 months prior. Knowledge was assessed via patient report at follow-up/post-program in 9 domains (yes/no), as well as heart-health behaviors and work status. Programs reported CR use, functional capacity, and risk factors. Results 4,309 patients from 17 programs in 11 countries were included, with 3359 (78.0%) having knowledge follow-up data. Total knowledge was high (8.1±1.3), highest regarding return to life roles, cardiac medications, and care plans. In an adjusted regression model, knowledge varied by region, country income, work status, function, quality of life and CR completion. Knowledge in specific domains was associated with corresponding health markers, including nutrition (p<0.001), medication adherence (p<0.001), and stress (p=0.009). Conclusions CR participants in diverse settings multinationally reported high disease management knowledge, with significant variation by regional, economic, and patient-level factors. Increased CR exposure, potentially in hybrid models, was associated with higher knowledge. This may be associated with improved health behaviors, and hence potentially better patient outcomes. Practical implications There is a need for tailored, evidence-based education strategies that address specific knowledge gaps and accommodate diverse patient populations.
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Shaubnaum et al. (2026) conducted an observational in Cardiovascular disease receiving phase II outpatient cardiac rehabilitation (n=4,309). Phase II outpatient cardiac rehabilitation was evaluated on Self-reported cardiovascular disease management knowledge across 9 domains (p=<0.001). Phase II outpatient cardiac rehabilitation yielded high post-program disease management knowledge (mean 8.1±1.3 of 9), correlating with nutrition and medication adherence (both p<0.001).
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