The Role of Lifestyle and Cardiovascular Risk Factors in Dropout From an Australian Cardiac Rehabilitation Program. A Longitudinal Cohort Study.

Rao, A; Zecchin, R; Byth, K; Denniss, AR; Hickman, LD; DiGiacomo, M; Phillips, JL; Newton, PJ

The Role of Lifestyle and Cardiovascular Risk Factors in Dropout From an Australian Cardiac Rehabilitation Program. A Longitudinal Cohort Study.

Rao, A

Zecchin, R Byth, K Denniss, AR Hickman, LD DiGiacomo, M

Phillips, JL Newton, PJ

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Publisher:: Elsevier
Publication Type:: Journal Article
Citation:: Heart Lung and Circulation, 2021, 30, (12), pp. 1891-1900
Issue Date:: 2021-07

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Field	Value	Language
dc.contributor.author	Rao, A https://orcid.org/0000-0002-7904-5556
dc.contributor.author	Zecchin, R
dc.contributor.author	Byth, K
dc.contributor.author	Denniss, AR
dc.contributor.author	Hickman, LD
dc.contributor.author	DiGiacomo, M https://orcid.org/0000-0001-5484-8224
dc.contributor.author	Phillips, JL
dc.contributor.author	Newton, PJ
dc.date.accessioned	2021-11-16T01:05:27Z
dc.date.available	2021-05-14
dc.date.available	2021-11-16T01:05:27Z
dc.date.issued	2021-07
dc.identifier.citation	Heart Lung and Circulation, 2021, 30, (12), pp. 1891-1900
dc.identifier.issn	1443-9506
dc.identifier.issn	1444-2892
dc.identifier.uri	http://hdl.handle.net/10453/151597
dc.description.abstract	Background Cardiac rehabilitation (CR) programs reduce the risk of further cardiac events and improve the ability of people living with cardiovascular disease to manage their symptoms. However, many people who experience a cardiac event do not attend or fail to complete their CR program. Little is known about the characteristics of people who drop out compared to those who complete CR. Aims To identify subgroups of patients attending a cardiac rehabilitation program who are more likely to dropout prior to final assessment by (1) calculating the dropout rate from the program, (2) quantifying the association between dropout and socio-demographic, lifestyle, and cardiovascular risk factors, and (3) identifying independent predictors of dropout. Methods The study population is from a large metropolitan teaching hospital in Sydney, Australia, and consists of all participants consecutively enrolled in an outpatient CR program between 2006 and 2017. Items assessed included diagnoses and co-morbidities, quality of life (SF-36), psychological health (DASS-21), lifestyle factors and physical assessment. Dropout was defined as failure to complete the outpatient CR program and post CR assessment. Results Of the 3,350 patients enrolled in the CR program, 784 (23.4%; 95%CI: 22.0–24.9%) dropped out prior to completion. The independent predictors of dropout were smoking (OR 2.4; 95%CI: 1.9–3.0), being separated or divorced (OR 2.0; 95%CI: 1.5–2.6), younger age (<55 years) (OR 1.9; 95%CI: 1.6–2.4), obesity (OR 1.6; 95%CI: 1.3–2.0), diabetes (OR 1.6; 95%CI: 1.3–2.0), sedentary lifestyle (OR 1.3; 95%CI: 1.1–1.6) and depressive symptoms (OR 1.3; 95%CI: 1.1–1.6). Conclusion To improve the CR program completion rate, clinicians need to consider the impact of socio-demographic, lifestyle, and cardiovascular risk factors on their patients’ ability to complete CR. Tailored strategies which target the independent predictors of dropout are required to promote adherence to CR programs and thereby potentially reduce long-term cardiovascular risk.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	Elsevier
dc.relation.ispartof	Heart Lung and Circulation
dc.relation.isbasedon	10.1016/j.hlc.2021.05.103
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology, 1117 Public Health and Health Services
dc.subject.classification	Cardiovascular System & Hematology
dc.subject.mesh	Australia
dc.subject.mesh	Cardiac Rehabilitation
dc.subject.mesh	Cardiovascular Diseases
dc.subject.mesh	Heart Disease Risk Factors
dc.subject.mesh	Humans
dc.subject.mesh	Life Style
dc.subject.mesh	Longitudinal Studies
dc.subject.mesh	Middle Aged
dc.subject.mesh	Quality of Life
dc.subject.mesh	Risk Factors
dc.title	The Role of Lifestyle and Cardiovascular Risk Factors in Dropout From an Australian Cardiac Rehabilitation Program. A Longitudinal Cohort Study.
dc.type	Journal Article
utslib.citation.volume	30
utslib.location.activity	Australia
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - CHT - Health Technologies
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Centre for Health Technologies (CHT)
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2021-11-16T01:05:26Z
pubs.issue	12
pubs.publication-status	Published
pubs.volume	30
utslib.citation.issue	12

Abstract:

Background Cardiac rehabilitation (CR) programs reduce the risk of further cardiac events and improve the ability of people living with cardiovascular disease to manage their symptoms. However, many people who experience a cardiac event do not attend or fail to complete their CR program. Little is known about the characteristics of people who drop out compared to those who complete CR. Aims To identify subgroups of patients attending a cardiac rehabilitation program who are more likely to dropout prior to final assessment by (1) calculating the dropout rate from the program, (2) quantifying the association between dropout and socio-demographic, lifestyle, and cardiovascular risk factors, and (3) identifying independent predictors of dropout. Methods The study population is from a large metropolitan teaching hospital in Sydney, Australia, and consists of all participants consecutively enrolled in an outpatient CR program between 2006 and 2017. Items assessed included diagnoses and co-morbidities, quality of life (SF-36), psychological health (DASS-21), lifestyle factors and physical assessment. Dropout was defined as failure to complete the outpatient CR program and post CR assessment. Results Of the 3,350 patients enrolled in the CR program, 784 (23.4%; 95%CI: 22.0–24.9%) dropped out prior to completion. The independent predictors of dropout were smoking (OR 2.4; 95%CI: 1.9–3.0), being separated or divorced (OR 2.0; 95%CI: 1.5–2.6), younger age (<55 years) (OR 1.9; 95%CI: 1.6–2.4), obesity (OR 1.6; 95%CI: 1.3–2.0), diabetes (OR 1.6; 95%CI: 1.3–2.0), sedentary lifestyle (OR 1.3; 95%CI: 1.1–1.6) and depressive symptoms (OR 1.3; 95%CI: 1.1–1.6). Conclusion To improve the CR program completion rate, clinicians need to consider the impact of socio-demographic, lifestyle, and cardiovascular risk factors on their patients’ ability to complete CR. Tailored strategies which target the independent predictors of dropout are required to promote adherence to CR programs and thereby potentially reduce long-term cardiovascular risk.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/151597