Charlotte Greve Sommer1, Lars Bo Jørgensen1,2,3, Birgitte Blume1, Tom Møller4, Søren Thorgaard Skou2,3, Alexander Harrison5, Lars Hermann Tang2,6. 1. Department of Occupational Therapy and Physiotherapy, Zealand University Hospital, Sygehusvej 10, 4000 Roskilde, Denmark. 2. Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Fælledvej 2c, DK-4200 Slagelse, Denmark. 3. Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, DK-5230 Odense M, Denmark. 4. The University Hospitals Centre for Health Research (UCSF), Copenhagen University Hospital, Rigshospitalet, Department 9701, Ryesgade 27, DK-2200 Copenhagen, Denmark. 5. Department of Health Sciences, University of York, Seebohm Rowntree Building Heslington York, YO10 5DD England, UK. 6. Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19, 3 5000 Odense C, Denmark.
Abstract
AIMS: Investigate the dropout rate during a 12-week transitional exercise-based cardiac rehabilitation (exCR) programme focusing on a halfway transition phase between hospital and the municipality-based cardiac rehabilitation. Secondly, investigate patient characteristics associated with dropout at the transition. METHODS AND RESULTS: Patients with coronary heart disease, heart failure, or heart valve surgery referred to exCR were included in a prospective cohort study conducted between 1 March 2018 and 28 February 2019 at Zealand University Hospital. Exercise-based cardiac rehabilitation was initiated at the hospital with a halfway transitional to local healthcare centres in the municipalities. Dropouts were identified every third week through telephone interviews. A Kaplan-Meier time-to-event analysis was used to investigate time to dropout, while multiple logistic regression assessed associations between patient characteristics and dropout at the transition. Of 560 patients eligible for exCR, 279 participated in the study. Fourteen patients were lost to follow-up and 103 dropped out, resulting in a dropout rate of 39% [95% confidence interval (CI) 33-45%]. Of the 103 dropouts, 72 patients (70%) dropped out at the transition. In the adjusted analysis, patients attached to the labour market were associated with dropout at the transition [odds ratio (OR) = 6.31 (95% CI 2.04-19.54)]. Furthermore, odds of dropping out at transition were reduced for each extra exercise session attended [OR = 0.79 (95% CI 0.66-0.94)]. CONCLUSION: The transition phase constitutes a critical dropout period in exCR, in which increased attention on patient adherence is needed. In clinical practice, communication and strategies addressing patient retention across settings could be essential to prevent dropout in transitional exCR. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Investigate the dropout rate during a 12-week transitional exercise-based cardiac rehabilitation (exCR) programme focusing on a halfway transition phase between hospital and the municipality-based cardiac rehabilitation. Secondly, investigate patient characteristics associated with dropout at the transition. METHODS AND RESULTS: Patients with coronary heart disease, heart failure, or heart valve surgery referred to exCR were included in a prospective cohort study conducted between 1 March 2018 and 28 February 2019 at Zealand University Hospital. Exercise-based cardiac rehabilitation was initiated at the hospital with a halfway transitional to local healthcare centres in the municipalities. Dropouts were identified every third week through telephone interviews. A Kaplan-Meier time-to-event analysis was used to investigate time to dropout, while multiple logistic regression assessed associations between patient characteristics and dropout at the transition. Of 560 patients eligible for exCR, 279 participated in the study. Fourteen patients were lost to follow-up and 103 dropped out, resulting in a dropout rate of 39% [95% confidence interval (CI) 33-45%]. Of the 103 dropouts, 72 patients (70%) dropped out at the transition. In the adjusted analysis, patients attached to the labour market were associated with dropout at the transition [odds ratio (OR) = 6.31 (95% CI 2.04-19.54)]. Furthermore, odds of dropping out at transition were reduced for each extra exercise session attended [OR = 0.79 (95% CI 0.66-0.94)]. CONCLUSION: The transition phase constitutes a critical dropout period in exCR, in which increased attention on patient adherence is needed. In clinical practice, communication and strategies addressing patient retention across settings could be essential to prevent dropout in transitional exCR. Published on behalf of the European Society of Cardiology. All rights reserved.