Literature DB >> 25797328

Education of Physicians and Implementation of a Formal Referral System Can Improve Cardiac Rehabilitation Referral and Participation Rates after Percutaneous Coronary Intervention.

Ali Dahhan1, William R Maddox2, Siva Krothapalli1, Matthew Farmer2, Amit Shah2, Benjamin Ford2, Marc Rhodes2, Laurie Matthews2, Vernon A Barnes3, Gyanendra K Sharma4.   

Abstract

BACKGROUND: Cardiac rehabilitation (CR) is an effective preventive measure that remains underutilised in the United States. The study aimed to determine the CR referral rate (RR) after percutaneous coronary intervention (PCI) at an academic tertiary care centre, identify barriers to referral, and evaluate awareness of CR benefits and indications (CRBI) among cardiologists. Subsequently, it aimed to evaluate if an intervention consisting of physicians' education about CRBI and implementation of a formal CR referral system could improve RR and consequently participation rate (PR).
METHODS: Data were retrospectively collected for all consecutive patients who underwent PCI over 12 months. Referral rate was determined and variables were compared for differences between referred and non-referred patients. A questionnaire was distributed among the physicians in the Division of Cardiology to assess awareness of CRBI and referral practice patterns. After implementation of the intervention, data were collected retrospectively for consecutive patients who underwent PCI in the following six months. Referral rate and changes in PRs were determined.
RESULTS: Prior to the intervention, RR was 17.6%. Different barriers were identified, but the questionnaire revealed lack of physicians' awareness of CRBI and inconsistent referral patterns. After the intervention, RR increased to 88.96% (Odds Ratio 37.73, 95% CI 21.34-66.70, p<0.0001) and PR increased by 32.8% to reach 26%. Personal endorsement of CRBI by cardiologists known to patients increased CR program graduation rate by 35%.
CONCLUSIONS: Cardiologists' awareness of CRBI increases CR RR and their personal endorsement improves PR and compliance. Education of providers and implementation of a formal referral system can improve RR and PR. Published by Elsevier B.V.

Entities:  

Keywords:  Cardiac rehabilitation; Education; Percutaneous coronary intervention; Prevention; Referral.

Mesh:

Year:  2015        PMID: 25797328     DOI: 10.1016/j.hlc.2015.02.006

Source DB:  PubMed          Journal:  Heart Lung Circ        ISSN: 1443-9506            Impact factor:   2.975


  8 in total

Review 1.  Cardiac Rehabilitation for Women: A Systematic Review of Barriers and Solutions.

Authors:  Marta Supervía; Jose R Medina-Inojosa; Colin Yeung; Francisco Lopez-Jimenez; Ray W Squires; Carmen M Pérez-Terzic; LaPrincess C Brewer; Shawn E Leth; Randal J Thomas
Journal:  Mayo Clin Proc       Date:  2017-03-13       Impact factor: 7.616

2.  Cardiac Specialists' Perspectives on Barriers to Cardiac Rehabilitation Referral and Participation in a Low-Resource Setting.

Authors:  Mahdieh Ghanbari-Firoozabadi; Masoud Mirzaei; Khadijeh Nasiriani; Mozhgan Hemati; Jamal Entezari; Mohammadreza Vafaeinasab; Sherry L Grace; Hasan Jafary; Seyed Mahmood Sadrbafghi
Journal:  Rehabil Process Outcome       Date:  2020-08-25

3.  Internal medicine resident education improves cardiac rehabilitation knowledge, attitudes, and referral rates: A pilot study.

Authors:  Maggie Wang; Nare Torosyan; C Noel Bairey-Merz; Janet Wei; Chrisandra L Shufelt
Journal:  Am J Prev Cardiol       Date:  2022-05-10

4.  Gains, losses, and uncertainties from computerizing referrals and consultations.

Authors:  Michael Weiner; April Savoy; Barry C Barker
Journal:  Appl Ergon       Date:  2020-08-05       Impact factor: 3.661

Review 5.  Current challenges in cardiac rehabilitation: strategies to overcome social factors and attendance barriers.

Authors:  Shahzad Chindhy; Pam R Taub; Carl J Lavie; Jia Shen
Journal:  Expert Rev Cardiovasc Ther       Date:  2020-09-14

6.  Introduction of a novel service model to improve uptake and adherence with cardiac rehabilitation within Buckinghamshire Healthcare NHS Trust.

Authors:  Fiona McCartan; Nicola Bowers; Jack Turner; Mirren Mandalia; Nayan Kalnad; Anna Bishop-Bailey; Jiayu Fu; Piers Clifford
Journal:  BMC Cardiovasc Disord       Date:  2017-07-11       Impact factor: 2.298

7.  Practices and attitudes of doctors and patients to downward referral in Shanghai, China.

Authors:  Wenya Yu; Meina Li; Xin Nong; Tao Ding; Feng Ye; Jiazhen Liu; Zhixing Dai; Lulu Zhang
Journal:  BMJ Open       Date:  2017-04-03       Impact factor: 2.692

8.  Successful Implementation and Development of a Phase II Cardiac Rehabilitation Program: A China-Wide Cross-Sectional Study Tracking In-service Training Clinical Staff.

Authors:  Xun Gong; Wenliang Zhang; Jeffrey W Ripley-Gonzalez; Yuan Liu; Yaoshan Dun; Fan Zheng; Ling Qiu; Suixin Liu
Journal:  Front Public Health       Date:  2021-03-17
  8 in total

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