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Factors associated with non-Attendance at exercise-based cardiac rehabilitation

Borg, Sabina; Öberg, Birgitta; Leosdottir, Margret LU ; Lindolm, Daniel; Nilsson, Lennart and Bäck, Maria (2019) In BMC Sports Science, Medicine and Rehabilitation 11(1).
Abstract

Background: Despite its well-established positive effects, exercise-based cardiac rehabilitation (exCR) is underused in patients following an acute myocardial infarction (AMI). The aim of the study was to identify factors associated with non-Attendance at exCR in patients post-AMI in a large Swedish cohort. Methods: A total of 31,297 patients who have suffered an AMI, mean age 62.4 ± 4 years, were included from the SWEDEHEART registry during the years 2010-2016. Comparisons between attenders and non-Attenders at exCR were done at baseline for the following variables: Age, sex, body mass index, occupational status, smoking, previous diseases, type of index cardiac event and intervention, and left ventricular function. Distance of... (More)

Background: Despite its well-established positive effects, exercise-based cardiac rehabilitation (exCR) is underused in patients following an acute myocardial infarction (AMI). The aim of the study was to identify factors associated with non-Attendance at exCR in patients post-AMI in a large Swedish cohort. Methods: A total of 31,297 patients who have suffered an AMI, mean age 62.4 ± 4 years, were included from the SWEDEHEART registry during the years 2010-2016. Comparisons between attenders and non-Attenders at exCR were done at baseline for the following variables: Age, sex, body mass index, occupational status, smoking, previous diseases, type of index cardiac event and intervention, and left ventricular function. Distance of residence from the hospital and type of hospital were added as structural variables in logistic regression analyses, with non-Attendance at exCR at one-year follow-up as dependent, and with individual and structural variables as independent variables. Results: In total, 16,214 (52%) of the patients did not attend exCR. The strongest predictor for non-Attendance was distance to the exCR centre (OR 1.75 [95% CI: 1.64-1.86]). Other predictors for non-Attendance included smoking, history of stroke, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), AMI or diabetes, male sex, being retired vs. being employed, and being followed-up at a county hospital. Patients with ST-elevation myocardial infarction (STEMI) and those intervened with PCI or CABG were more likely to attend exCR. Conclusions: A distance greater than 16 km was associated with increased probability of non-Attendance at exCR, as were smoking, a higher burden of comorbidities, and male sex. A better understanding of individual and structural factors can support the development of future rehabilitation services.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute myocardial infarction, Coronary artery disease, Exercise-based cardiac rehabilitation, Non-Attendance, Physiotherapy, Secondary prevention
in
BMC Sports Science, Medicine and Rehabilitation
volume
11
issue
1
publisher
BioMed Central
external identifiers
  • scopus:85069955100
ISSN
2052-1847
DOI
10.1186/s13102-019-0125-9
language
English
LU publication?
yes
id
f5245688-cbce-4875-9646-66751929f5ce
date added to LUP
2019-08-28 16:46:06
date last changed
2019-09-04 04:49:25
@article{f5245688-cbce-4875-9646-66751929f5ce,
  abstract     = {<p>Background: Despite its well-established positive effects, exercise-based cardiac rehabilitation (exCR) is underused in patients following an acute myocardial infarction (AMI). The aim of the study was to identify factors associated with non-Attendance at exCR in patients post-AMI in a large Swedish cohort. Methods: A total of 31,297 patients who have suffered an AMI, mean age 62.4 ± 4 years, were included from the SWEDEHEART registry during the years 2010-2016. Comparisons between attenders and non-Attenders at exCR were done at baseline for the following variables: Age, sex, body mass index, occupational status, smoking, previous diseases, type of index cardiac event and intervention, and left ventricular function. Distance of residence from the hospital and type of hospital were added as structural variables in logistic regression analyses, with non-Attendance at exCR at one-year follow-up as dependent, and with individual and structural variables as independent variables. Results: In total, 16,214 (52%) of the patients did not attend exCR. The strongest predictor for non-Attendance was distance to the exCR centre (OR 1.75 [95% CI: 1.64-1.86]). Other predictors for non-Attendance included smoking, history of stroke, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), AMI or diabetes, male sex, being retired vs. being employed, and being followed-up at a county hospital. Patients with ST-elevation myocardial infarction (STEMI) and those intervened with PCI or CABG were more likely to attend exCR. Conclusions: A distance greater than 16 km was associated with increased probability of non-Attendance at exCR, as were smoking, a higher burden of comorbidities, and male sex. A better understanding of individual and structural factors can support the development of future rehabilitation services.</p>},
  articleno    = {13},
  author       = {Borg, Sabina and Öberg, Birgitta and Leosdottir, Margret and Lindolm, Daniel and Nilsson, Lennart and Bäck, Maria},
  issn         = {2052-1847},
  keyword      = {Acute myocardial infarction,Coronary artery disease,Exercise-based cardiac rehabilitation,Non-Attendance,Physiotherapy,Secondary prevention},
  language     = {eng},
  month        = {07},
  number       = {1},
  publisher    = {BioMed Central},
  series       = {BMC Sports Science, Medicine and Rehabilitation},
  title        = {Factors associated with non-Attendance at exercise-based cardiac rehabilitation},
  url          = {http://dx.doi.org/10.1186/s13102-019-0125-9},
  volume       = {11},
  year         = {2019},
}