OBJECTIVE: Secondary prevention programs such as cardiovascular rehabilitation significantly decrease the burden of cardiovascular disease, yet are under-used. The most successful strategy to promote cardiovascular rehabilitation utilization is systematic referral with a patient-provider discussion. This study investigated: (i) the elements of patient-provider discussions related to patient cardiovascular rehabilitation enrollment, and (ii) the frequency and correlates of these discussion elements. DESIGN/PARTICIPANTS: This was a prospective study of cardiovascular patients and their healthcare providers. Discussions about "secondary prevention" were audio-recorded. Utterances were coded using the Roter Interaction Analysis System. Two months later, cardiovascular rehabilitation enrollment was ascertained. RESULTS: Discussions between 26 healthcare providers and 50 patients were recorded, of whom 27 (54.0%) enrolled in cardiovascular rehabilitation. Participants were significantly more likely to enroll in cardiovascular rehabilitation when their healthcare providers offered less reassurance and optimism (odds ratio (OR) = 0.81), and when the patient asked more questions related to lifestyle (OR = 4.98). These were not common. CONCLUSION: While caution is warranted due to the number of comparisons undertaken such that associations observed may be chance associations, these novel findings suggest that not overstating the beneficial effects of acute treatment, and allowing patients more time to ask questions about needed lifestyle changes should be investigated in future research.
OBJECTIVE: Secondary prevention programs such as cardiovascular rehabilitation significantly decrease the burden of cardiovascular disease, yet are under-used. The most successful strategy to promote cardiovascular rehabilitation utilization is systematic referral with a patient-provider discussion. This study investigated: (i) the elements of patient-provider discussions related to patient cardiovascular rehabilitation enrollment, and (ii) the frequency and correlates of these discussion elements. DESIGN/PARTICIPANTS: This was a prospective study of cardiovascular patients and their healthcare providers. Discussions about "secondary prevention" were audio-recorded. Utterances were coded using the Roter Interaction Analysis System. Two months later, cardiovascular rehabilitation enrollment was ascertained. RESULTS: Discussions between 26 healthcare providers and 50 patients were recorded, of whom 27 (54.0%) enrolled in cardiovascular rehabilitation. Participants were significantly more likely to enroll in cardiovascular rehabilitation when their healthcare providers offered less reassurance and optimism (odds ratio (OR) = 0.81), and when the patient asked more questions related to lifestyle (OR = 4.98). These were not common. CONCLUSION: While caution is warranted due to the number of comparisons undertaken such that associations observed may be chance associations, these novel findings suggest that not overstating the beneficial effects of acute treatment, and allowing patients more time to ask questions about needed lifestyle changes should be investigated in future research.
Authors: Ralph L Sacco; Robert Adams; Greg Albers; Mark J Alberts; Oscar Benavente; Karen Furie; Larry B Goldstein; Philip Gorelick; Jonathan Halperin; Robert Harbaugh; S Claiborne Johnston; Irene Katzan; Margaret Kelly-Hayes; Edgar J Kenton; Michael Marks; Lee H Schwamm; Thomas Tomsick Journal: Stroke Date: 2006-02 Impact factor: 7.914
Authors: Balraj S Heran; Jenny Mh Chen; Shah Ebrahim; Tiffany Moxham; Neil Oldridge; Karen Rees; David R Thompson; Rod S Taylor Journal: Cochrane Database Syst Rev Date: 2011-07-06
Authors: Peter L Prior; Vladimir Hachinski; Karen Unsworth; Richard Chan; Sharon Mytka; Christina O'Callaghan; Neville Suskin Journal: Stroke Date: 2011-09-22 Impact factor: 7.914
Authors: Francesca Dwamena; Margaret Holmes-Rovner; Carolyn M Gaulden; Sarah Jorgenson; Gelareh Sadigh; Alla Sikorskii; Simon Lewin; Robert C Smith; John Coffey; Adesuwa Olomu Journal: Cochrane Database Syst Rev Date: 2012-12-12
Authors: Sherry L Grace; Kelly L Russell; Robert D Reid; Paul Oh; Sonia Anand; James Rush; Karen Williamson; Milan Gupta; David A Alter; Donna E Stewart Journal: Arch Intern Med Date: 2011-02-14
Authors: Jose A Suaya; Donald S Shepard; Sharon-Lise T Normand; Philip A Ades; Jeffrey Prottas; William B Stason Journal: Circulation Date: 2007-09-24 Impact factor: 29.690
Authors: Sherry L Grace; Kelly L Angevaare; Robert D Reid; Paul Oh; Sonia Anand; Milan Gupta; Stephanie Brister; Donna E Stewart Journal: Implement Sci Date: 2012-12-13 Impact factor: 7.327
Authors: Carolina Santiago de Araújo Pio; Gabriela Ss Chaves; Philippa Davies; Rod S Taylor; Sherry L Grace Journal: Cochrane Database Syst Rev Date: 2019-02-01