Can We Predict Who Will Complete a Cardiac Rehabilitation Exercise Programme?

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of death in New Zealand. While the benefits of undertaking a Cardiac Rehabilitation Exercise programme (CREP) are well documented, attendance at and completion of such programmes is frequently reported as low, with a multiplicity of factors influencing nonattendance. The Auckland University Health and Rehabilitation Clinic (HRC), a research and student training centre that provides high quality evidence-based exercise rehabilitation services for people living with heart disease and other chronic illnesses, were interested in identifying the key characteristics that differentiate those participants who complete a CREP from those who do not. The purpose of this study is to determine whether it is possible to predict reliably which patients will complete a CREP, based on demographic and fitness assessment data, and the results of selfadministered health, wellbeing, and Barriers to Exercise questionnaires. Method: A multivariate logistic regression analysis was undertaken on HRC cardiac patients, with comparison being made between those patients who had undertaken the final exercise completion test and those that had not. Results: Significant predictors of programme completion were Waist Circumference size, and responses to Barriers to Exercise questions regarding Lack of Motivation and Lack of Childcare We found no difference between the Completed/Noncompleted groups with respect to age, gender, BMI, anxiety or depression, with a difference between groups for VO2peak being only weakly significant. Because the sample selection was not a randomised selection of all patients who attended the clinic during the selection period, the results of this analysis are not generalisable to a wider population. Conclusion: When waist circumference size increases, or there is an increase in the Barriers to Exercise questionnaire responses for Lack of Motivation, and Lack of Childcare, the odds of completing a CREP fall. Use of these predictive variables to model the likelihood of CREP completion could assist with the development of effective personalised rehabilitation programmes and help improve patient health and wellbeing following cardiac events. Key words: Cardiovascular Disease, Cardiac rehabilitation, exercise based cardiac rehabilitation, logistic regression