TY - JOUR
T1 - Offering, participation and adherence to cardiac rehabilitation programmes in the elderly
T2 - a European comparison based on the EU-CaRE multicentre observational study
AU - Gonzalez-Salvado, Violeta
AU - Pena-Gil, Carlos
AU - Lado-Baleato, Oscar
AU - Cadarso-Suarez, Carmen
AU - Prada-Ramallal, Guillermo
AU - Prescott, Eva
AU - Wilhelm, Matthias
AU - Eser, Prisca
AU - Iliou, Marie-Christine
AU - Zeymer, Uwe
AU - Ardissino, Diego
AU - Bruins, Wendy
AU - van der Velde, Astrid E.
AU - Van't Hof, Arnoud W. J.
AU - de Kluiver, Ed P.
AU - Kolkman, Evelien K.
AU - Prins, Leonie
AU - Gonzalez Juanatey, Jose Ramon
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this project has received funding from the European Union's Horizon 2020 research and innovation programme (grant agreement: 634439) and from the Swiss State Secretariat for Education, Research and Innovation for the Swiss consortium partner.
Publisher Copyright:
© 2021 The Author(s).
PY - 2021/5
Y1 - 2021/5
N2 - Aims: Cardiac rehabilitation (CR) is strongly recommended but participation of elderly patients has not been well characterized. This study aims to analyse current rates and determinants of CR referral, participation, adherence, and compliance in a contemporary European cohort of elderly patients. Methods and results: The EU-CaRE observational study included data from consecutive patients aged ≥ 65 with acute coronary syndrome, revascularization, stable coronary artery disease, or heart valve replacement, recruited in eight European centres. Rates and factors determining offering, participation, and adherence to CR programmes and compliance with training sessions were studied across centres, under consideration of extensive-outpatient vs. intensive-inpatient programmes. Three thousand, four hundred, and seventy-one patients were included in the offering and participation analysis. Cardiac rehabilitation was offered to 80.8% of eligible patients, formal contraindications being the main reason for not offering CR. Mean participation was 68.0%, with perceived lack of usefulness and transport issues being principal barriers. Mean adherence to CR programmes of participants in the EU-CaRE study (n = 1663) was 90.3%, with hospitalization/physical impairment as principal causes of dropout. Mean compliance with training sessions was 86.1%. Older age was related to lower offering and participation, and comorbidity was associated with lower offering, participation, adherence, and compliance. Intensive-inpatient programmes displayed higher adherence (97.1% vs. 85.9%, P < 0.001) and compliance (full compliance: 66.0% vs. 38.8%, P < 0.001) than extensive-outpatient programmes. Conclusion: In this European cohort of elderly patients, older age and comorbidity tackled patients' referral and uptake of CR programmes. Intensive-inpatient CR programmes showed higher completion than extensive-outpatient CR programmes, suggesting this formula could suit some elderly patients.
AB - Aims: Cardiac rehabilitation (CR) is strongly recommended but participation of elderly patients has not been well characterized. This study aims to analyse current rates and determinants of CR referral, participation, adherence, and compliance in a contemporary European cohort of elderly patients. Methods and results: The EU-CaRE observational study included data from consecutive patients aged ≥ 65 with acute coronary syndrome, revascularization, stable coronary artery disease, or heart valve replacement, recruited in eight European centres. Rates and factors determining offering, participation, and adherence to CR programmes and compliance with training sessions were studied across centres, under consideration of extensive-outpatient vs. intensive-inpatient programmes. Three thousand, four hundred, and seventy-one patients were included in the offering and participation analysis. Cardiac rehabilitation was offered to 80.8% of eligible patients, formal contraindications being the main reason for not offering CR. Mean participation was 68.0%, with perceived lack of usefulness and transport issues being principal barriers. Mean adherence to CR programmes of participants in the EU-CaRE study (n = 1663) was 90.3%, with hospitalization/physical impairment as principal causes of dropout. Mean compliance with training sessions was 86.1%. Older age was related to lower offering and participation, and comorbidity was associated with lower offering, participation, adherence, and compliance. Intensive-inpatient programmes displayed higher adherence (97.1% vs. 85.9%, P < 0.001) and compliance (full compliance: 66.0% vs. 38.8%, P < 0.001) than extensive-outpatient programmes. Conclusion: In this European cohort of elderly patients, older age and comorbidity tackled patients' referral and uptake of CR programmes. Intensive-inpatient CR programmes showed higher completion than extensive-outpatient CR programmes, suggesting this formula could suit some elderly patients.
KW - Ageing
KW - Secondary prevention
KW - Referral
KW - Compliance
KW - Cardiovascular disease
KW - Cardiac rehabilitation
KW - QUALITY-OF-LIFE
KW - COST-EFFECTIVENESS
U2 - 10.1093/eurjpc/zwaa104
DO - 10.1093/eurjpc/zwaa104
M3 - Article
C2 - 33558875
SN - 2047-4873
VL - 28
SP - 558
EP - 568
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
IS - 5
ER -