A comparison of barriers to use of home versus site-based cardiac rehabilitation

Shanmugasegaram, Shamila; Oh, Paul; Reid, Robert D; McCumber, Treva; Grace, Sherry L.

A comparison of barriers to use of home versus site-based cardiac rehabilitation

dc.contributor.author	Shanmugasegaram, Shamila
dc.contributor.author	Oh, Paul
dc.contributor.author	Reid, Robert D
dc.contributor.author	McCumber, Treva
dc.contributor.author	Grace, Sherry L.
dc.date.accessioned	2014-06-11T13:05:40Z
dc.date.available	2014-06-11T13:05:40Z
dc.date.issued	2013-09
dc.description.abstract	Purpose: Despite the established benefits of cardiac rehabilitation (CR), it remains significantly underutilized. It is unknown whether patient barriers to enrollment and adherence are addressed by offering choice of program type. The purpose of this study was to examine barriers to participation in CR by program type (site vs. home-based), and the relation of these barriers to degree of program participation and exercise behavior. Method: 1809 cardiac patients from 11 hospitals across Ontario completed a sociodemographic survey in-hospital, and clinical data were extracted from charts. They were mailed a follow-up survey one year later, which included the Cardiac Rehabilitation Barriers Scale and the Physical Activity Scale for the Elderly. Participants were also asked whether they attended CR, the type of program model attended, and the percentage of prescribed sessions completed. Results: Overall, 939 (51.9%) patients participated in CR, with 96 (10.3%) participating in a home-based program. Home-based participants reported significantly greater CR barriers compared to site-based participants (p<0.001), including distance. Mean barrier scores were significantly and negatively related to session completion and physical activity among site-based (ps<0.05), but not home-based CR participants (p>0.05). Conclusion: The barriers to CR are significantly different among patients attending site vs. home-based program, suggesting appropriate use of alternative models of care. Patient preferences should be considered when allocating patients to program models. Once in CR, programs should work towards identifying and tackling barriers among site-based participants. Abstract word count=231	en_US
dc.description.sponsorship	This study was funded by Canadian Institutes of Health Research (CIHR) and Heart and Stroke Foundation of Canada grant #HOA-80676. Ms. Shanmugasegaram is supported in her graduate studies by the CIHR Frederick Banting and Charles Best Canada Graduate Scholarship Doctoral Award. In addition, Dr. Grace is supported by CIHR salary award #MSH-80489.
dc.identifier.citation	J Cardiopulm Rehabil Prev. 2013 Sep-Oct;33(5):297-302. doi: 10.1097/HCR.0b013e31829b6e81.
dc.identifier.uri	http://hdl.handle.net/10315/27536
dc.identifier.uri	https://dx.doi.org/10.1097/HCR.0b013e31829b6e81
dc.language.iso	en	en
dc.publisher	Journal of Cardiopulmonary Rehabilitation and Prevention
dc.rights.journal	journals.lww.com/jcrjournal/pages/default.aspx
dc.title	A comparison of barriers to use of home versus site-based cardiac rehabilitation
dc.type	Article