An Early Appointment to Outpatient Cardiac Rehabilitation at Hospital Discharge Improves Attendance at Orientation: A Randomized, Single-Blind, Controlled Trial.
Circulation. 2012 Dec 18;
Authors: Pack QR, Mansour M, Barboza JS, Hibner BA, Mahan MG, Ehrman JK, Vanzant MA, Schairer JR, Keteyian SJ
Abstract
BACKGROUND: Outpatient cardiac rehabilitation (CR) decreases mortality rates but is underutilized. Current median time from hospital discharge to enrollment is 35 days. We hypothesized that an appointment within 10 days would improve attendance at CR orientation. METHODS AND RESULTS: At hospital discharge, 148 patients with a non-surgical qualifying diagnosis for cardiac rehabilitation were randomized to receive a CR orientation appointment either within 10 days (early, E) or at 35 days (standard, STD). The primary endpoint was attendance at CR orientation. Secondary outcome measures were attendance at ?1 exercise session, the total number of exercise sessions attended, completion of CR, and change in exercise training work load while in CR. Average age was 60 ± 12 yr., 56% male, 49% Black, with balanced baseline characteristics between groups. Median time (95% CI) to orientation was 8.5 (7 to 13) vs. 42 (35 to -) days for the E and STD groups, respectively (p < 0.001). Attendance rates at the orientation session were 57/74 (77%) vs. 44/74 (59%) for E and STD groups respectively, demonstrating a significant 18% absolute and 56% relative improvement (RR 1.56, 95% CI, 1.03 to 2.37; p = 0.022). The number needed to treat was 5.7. There was no difference (p>0.05) in any of the secondary outcome measures but statistical power for these endpoints was low. Safety analysis demonstrated no difference between groups in CR-related adverse events. CONCLUSIONS: Early appointments to CR significantly improve attendance at orientation. This simple technique could potentially increase initial CR participation nationwide. CLINICAL TRIAL REGISTRATION INFORMATION: clinicaltrials.gov; Identifier: NCT01596036.
PMID: 23250992 [PubMed - as supplied by publisher]