Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial

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Date

2016-02-01

Authors

Grace, Sherry
Midence, Liz
Oh, Paul
Brister, Stephanie
Chessex, Caroline
Stewart, Donna Eileen
Arthur, Heather M.

Journal Title

Journal ISSN

Volume Title

Publisher

Elsevier

Abstract

Objective

To compare program adherence and functional capacity between women referred to supervised mixed-sex, supervised women-only, or home-based cardiac rehabilitation (CR).

Patients and Methods

Cardiac Rehabilitation for Heart Event Recovery (CR4HER) was a single-blind, 3 parallel-arm, pragmatic randomized controlled trial. The study took place between November 1, 2009, and July 31, 2013. Low-risk patients with coronary artery disease were recruited from 6 hospitals in Ontario, Canada. Consenting participants completed a preprogram survey, and clinical data were extracted from charts. Participants were referred to CR at 1 of 3 sites. After intake assessment, including a graded exercise stress test, eligible patients were randomized to supervised mixed-sex, supervised women-only, or home-based CR. Six months later, CR adherence and exit assessment data were ascertained.

Results

Of the 264 consenting patients, 169 (64.0%) were eligible and randomized. Twenty-seven (16.0%) did not attend, and 43 (25.4%) attended a different model. Program adherence was moderate overall (54.46%±35.14%). Analysis of variance revealed no significant differences based on per-protocol analysis (P=.63), but as-treated, home-based participants attended significantly more than did women-only participants (P<.05). Overall, there was a significant increase in functional capacity preprogram to postprogram (P<.001). Although there were no significant differences in functional capacity by model at CR exit based on per-protocol analysis, there was a significant difference on an as-treated basis, which sustained adjustment. Women attending mixed-sex CR attained significantly higher post-CR functional capacity than did women attending home-based programs (P<.05).

Conclusion

Offering women alternative program models may not promote greater CR adherence or functional capacity; however, replication is warranted. Other proven strategies such as action planning and self-monitoring should be applied.

Trial Registration

clinicaltrials.gov Identifier: NCT01019135.

Description

© 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. This article is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/

Keywords

Citation

Grace, S. L., Midence, L., Oh, P., Brister, S., Chessex, C., Stewart, D. E., & Arthur, H. M. (2016). Cardiac Rehabilitation Program Adherence and Functional Capacity Among Women: A Randomized Controlled Trial. Mayo Clinic Proceedings, 91(2), 140–148. https://doi.org/10.1016/j.mayocp.2015.10.021