Factors Associated With Attendance at a 1-yr Post–Cardiac Rehabilitation Risk Factor Check

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.