Nurse-delivered MI-CBT did not improve cardiac rehabilitation enrolment, attendance, mortality, or readmission compared to matched historical controls; patients in 2022 attended 2 fewer lifestyle sessions (p<0.001).
Observational
Yes
Does a nurse-delivered MI-CBT intervention improve patient enrolment, attendance, mortality, or readmission rates in patients referred to cardiac rehabilitation?
797 patients registered with the Auckland health district nurse-delivered cardiac rehabilitation outpatient clinic in 2022, mean age 64.6 years, 29.2% female.
Nurse-delivered Motivational Interviewing and Cognitive Behavioural Therapy (MI-CBT) intervention integrated into initial outpatient clinics to encourage cardiac rehabilitation enrolment and engagement.
Propensity score-matched historical cohort of patients registered with the same cardiac rehabilitation programme between 2016 and 2020 (n=779 matched).
Patient enrolment, engagement (attendance), and clinical outcomes including all-cause mortality and hospital readmissions.
A nurse-delivered MI-CBT intervention did not improve cardiac rehabilitation enrolment, attendance, or clinical outcomes compared to a historical cohort, though pandemic-related disruptions may have influenced the results.
A nurse-delivered MI-CBT intervention did not enhance cardiac rehabilitation enrolment or attendance. However, programme stability despite pandemic-related challenges suggests resilience. Future research should explore alternative patient engagement strategies and assess MI-CBT fidelity. Findings contribute to understanding participation barriers and inform ongoing service improvements.
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Paul W. Marshall
Raewyn Fisher
P. M. O'Halloran
Heart Lung and Circulation
University of Auckland
La Trobe University
Western Sydney University
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Marshall et al. (Sun,) conducted a observational in Patients referred to outpatient cardiac rehabilitation following acute cardiac events in Auckland, New Zealand in 2022 (n=797). Nurse-specialist-delivered motivational interviewing combined with cognitive behavioural therapy (MI-CBT) intervention vs. Propensity score-matched historical cohort patients from 2016-2020 who received usual cardiac rehabilitation was evaluated on Cardiac rehabilitation enrolment and attendance, all-cause mortality, and hospital readmissions over average 1.56 years follow-up (p=p=0.74 for mortality, p=0.71 for all-cause cardiac readmission after matching; no significant differences in enrolment or attendance). Nurse-delivered MI-CBT did not improve cardiac rehabilitation enrolment, attendance, mortality, or readmission compared to matched historical controls; patients in 2022 attended 2 fewer lifestyle sessions (p<0.001).
www.synapsesocial.com/papers/69a1344fed1d949a99abe0cc — DOI: https://doi.org/10.1016/j.hlc.2025.10.006