Assessing and optimizing patient-provider communication regarding cardiovascular rehabilitation (VRCOMM)

"Cardiovascular rehabilitation (CR) is proven to reduce morbidity and mortality in cardiac patients. Despite the evidence of benefit, only 15-20% of patients participate. The most successful strategy to promote CR utilization is systematic referral through healthcare provider (HCP) discussions with the patients. The objectives of this study were to: (1) describe patient-HCP interaction regarding CR at the bedside, and (2) investigate which elements were related to patient referral and enrollment.

This was a prospective study of cardiovascular patients (n=58) and their HCPs (n=60) who received, a digital audiorecorder to record their subsequent interaction, about ""secondary prevention"". All HCP and patient participants completed a self-report survey assessing sociodemographic characteristics, perceptions of CR and their clinical interaction. Fifty patient-HCP interactions were successfully digitally recorded and coded using the Roter Interaction Analysis System, a method of coding medical dialogue.

The results show that, CR referral- making following a cardiovascular event was not allocated to a specific HCP; therefore HCP awareness of patient's referral was incredibly low. Some elements of patient-HCP communication were significantly related to patient referral and enrollment in CR programs weeks later. These elements were: greater HCP interactivity, less patient concern and worry, less HCP reassurance and optimism, and more time allocated to patient questions related to lifestyle. Further tests is needed to examine whether HCPs can be trained to communicate with cardiovascular patients in a manner that enhances CR enrollment rates."