Interventions to Promote Patient Utilization of Cardiac Rehabilitation: Cochrane Systematic Review and Meta-Analysis

dc.contributor.authorSantiago de Araújo Pio, Carolina
dc.contributor.authorChaves, Gabriela
dc.contributor.authorDavies, Philippa
dc.contributor.authorTaylor, Rod
dc.contributor.authorGrace, Sherry L.
dc.date.accessioned2020-03-11T18:21:01Z
dc.date.available2020-03-11T18:21:01Z
dc.date.issued2019-02-05
dc.description.abstractToo few patients utilize cardiac rehabilitation (CR), despite its benefits. The Cochrane review assessing the effectiveness of interventions to increase CR utilization (enrolment, adherence, and completion) was updated. A search was performed through July 2018 of the Cochrane and MEDLINE (Medical Literature Analysis and Retrieval System Online) databases, among other sources. Randomized controlled trials in adults with myocardial infarction, angina, revascularization, or heart failure were included. Interventions had to aim to increase utilization of comprehensive phase II CR. Two authors independently performed all stages of citation processing. Following the random-effects meta-analysis, meta-regression was undertaken to explore the impact of pre-specified factors. Twenty-six trials with 5299 participants were included (35.8% women). Low-quality evidence showed an effect of interventions in increasing enrolment (risk ratio (RR) = 1.27, 95% confidence interval (CI) = 1.13–1.42). Meta-regression analyses suggested that the intervention deliverer (nurse or allied healthcare provider, p = 0.02) and delivery format (face-to-face, p = 0.01) were influential in increasing enrolment. There was low-quality evidence that interventions to increase adherence were effective (standardized mean difference (SMD) = 0.38, 95% CI = 0.20–0.55), particularly where remotely-offered (SMD = 0.56, 95% CI = 0.36–0.76). There was moderate-quality evidence that interventions to increase program completion were effective (RR = 1.13, 95% CI = 1.02–1.25). There are effective interventions to increase CR utilization, but more research is needed to establish specific, implementable materials and protocols, particularly for completion.en_US
dc.description.sponsorshipYork University Librariesen_US
dc.identifier.citationJournal of Clinical Medicine 8.2 (2019): 189.en_US
dc.identifier.urihttps://doi.org/10.3390/jcm8020189en_US
dc.identifier.urihttps://hdl.handle.net/10315/37102
dc.language.isoenen_US
dc.publisherMDPIen_US
dc.rightsAttribution 2.5 Canada*
dc.rights.articlehttps://www.mdpi.com/2077-0383/8/2/189en_US
dc.rights.journalhttps://www.mdpi.com/journal/jcmen_US
dc.rights.publisherhttps://www.mdpi.com/en_US
dc.rights.urihttp://creativecommons.org/licenses/by/2.5/ca/*
dc.subjectcoronary artery diseaseen_US
dc.subjectsecondary preventionen_US
dc.subjecthealthcare accessen_US
dc.subjectcardiac rehabilitationen_US
dc.titleInterventions to Promote Patient Utilization of Cardiac Rehabilitation: Cochrane Systematic Review and Meta-Analysisen_US
dc.typeArticleen_US

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