Faculty of Health
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Browsing Faculty of Health by Author "Aggarwal, Sandeep"
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Item Open Access Factors Associated With Attendance at a 1-yr Post–Cardiac Rehabilitation Risk Factor Check(Lippincott, Williams & Wilkins, 2020-05) Giannoccaro, Justin; Aggarwal, Sandeep; Grace, Sherry; Campbell, Tavis S.; Hauer, Trina; Arena, Ross; Rouleau, Codie R.Purpose: Patients with coronary artery disease (CAD) often fail to maintain secondary prevention gains after completing cardiac rehabilitation (CR). Follow-up appointments aimed at assessing cardiac status and encouraging maintenance of health behaviors after CR completion are generally offered, but not well-attended. This study explored patient characteristics and barriers associated with non-attendance at a one-year follow-up visit following CR completion. Methods: Forty-five patients with CAD who completed a 12-week outpatient CR program but did not attend the one-year follow-up appointment were included. Participants responded to a survey consisting of open-ended questions about follow-up attendance, a modified version of the Cardiac Rehabilitation Barriers Scale, and self-report items regarding current health practices and perceived strength of recommendation to attend. Thematic analysis was used to derive categories from open-ended questionnaire responses. Linear regression was used to assess characteristics associated with appointment attendance barriers. Results: Barrier themes were: 1) lack of awareness, 2) perception of appointment as unnecessary, 3) practical or scheduling issues, 4) comorbid health issues, and 5) anticipated an unpleasant experience at the appointment. Greater self-reported barriers (M=1.97/5.00 ± 0.57) were significantly associated with lower perceived strength of recommendation to attend the follow-up appointment (M=2.82/5.00 ± 1.45), p=.005. Conclusions: Providing a stronger recommendation to attend, enhancing patient awareness, highlighting potential benefits, and supporting self-efficacy might increase one-year follow-up appointment attendance and, in turn, support long-term adherence to cardiovascular risk reduction behaviors.Item Open Access Feasibility of Assessing 2 Cardiac Rehabilitation Quality Indicators(Wolters Kluwer, 2016-03) Grace, Sherry; Tan, Yongyao; Oh, Paul; Aggarwal, Sandeep; Unsworth, Karen; Suskin, NevillePurpose: The Canadian Cardiovascular Society initiated a pan-Canadian process for development of quality indicators (QIs) for cardiac rehabilitation (CR). Before implementation, the QIs underwent pilot testing to ensure they were acceptable and feasible for field implementation. The objectives of this test were to assess (1) the technical feasibility of measuring the QIs; (2) the workload required to measure the QIs; and (3) acceptability of measuring the QIs and issues with their implementation. Methods: The 2 indicators chosen for field testing were QI-1 (% of eligible inpatients referred) and 2b (median wait time from CR referral receipt to enrollment). The approach consisted of 3 steps: (1) data extraction to test technical feasibility; (2) completing a workload diary; and (3) providing input through a semi structured interview regarding acceptability and implementation issues. Three academic CR sites were selected to undertake the field test. Results: QI-1 ranged from 51.0% to 68.4%, and QI-2b was reported as 27 days (median) by one site, and 22 days (mean) by another. It was not considered feasible for CR programs to assess all potentially CR-eligible inpatients for CR referral exclusions. Compilation required 4.2 hours for QI-1 and 1.8 hours for QI-2b. QI assessment was acceptable to the programs, but changes in practice would be needed at each site to implement the QIs. Conclusions: CR programs may require enhancement of information-tracking processes to enable QI measurement. It was recommended that the QIs be implemented, but should undergo minor revisions to enhance feasibility.