Promoting Patient Utilization of Cardiac Rehabilitation - Systematic Review and Knowledge Translation

Cardiac Rehabilitation (CR) is a proven, cost-effective outpatient model of care for secondary prevention of cardiovascular disease (CVD), a highly prevalent health condition worldwide. Unfortunately, despite the existence of some guidelines with recommendations to refer CVD patients to CR, rates of CR utilization are low. Lack of strong and supportive endorsement by a healthcare provider may serve as a barrier to utilization. The overall aim of the doctoral dissertation is to advance scholarly understanding and knowledge translation to promote CR utilization. For this purpose, three interlinked research studies were undertaken. Using rigorous Cochranes methodological standards, I first updated the Cochrane systematic review on interventions to promote patient utilization of CR. Next, the first-ever position statement on implementable recommendations to increase patient utilization of CR was developed in accordance with AGREE II, among other guideline checklists, to build on the findings of the updated systematic review. Finally, following Kirkpatricks framework in a multi-method study, an online course for healthcare providers was developed and tested to promote the implementation of the recommendations gained from the earlier work. The present dissertation is fundamental in the identification and knowledge transfer of effective interventions to promote patient utilization of CR programs. The recommendations and tools developed herein will potentially guide policy-makers, healthcare providers and cardiac patients towards greater utilization of CR and therefore, reduction of CVD risk.