Patient characteristics of non-participants and reasons for non-participation in cardiac (tele)rehabilitation-a prospective analysis.
Rutger F R van Mierlo, Fleur W W Heijkens-Verberkt, Vitalis J G Houben and 5 others
PMID 42254476WHAT IT FOUND
Of 328 patients who agreed to a rehabilitation study after a heart attack, 200 took part in the hospital programme, 64 took the home app programme and 64 took neither.
Non-participants were older, and most said they were simply not interested.
Key findings
01Of 328 patients who consented, 200 (61%) took part in centre-based rehabilitation, 64 (20%) in telerehabilitation and 64 (20%) in neither, once actual attendance was checked rather than intended choices.
02Non-participants were older (69 ± 11 years) than patients who chose centre-based rehabilitation (64 ± 10 years) or telerehabilitation (61 ± 10 years), p < 0.001.
03The most common reason for not taking part was being uninterested or judging cardiac rehabilitation unnecessary (37 people, 58%), with 13 (20%) instead going to a primary care physiotherapist.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only patients who agreed to join the trial were followed, so the 61% participation rate is likely higher than in the whole heart attack population. The authors say self-selection bias probably inflated it and that they cannot measure by how much. Patients chose their own programme instead of being randomly assigned, so the three groups differ in ways the study cannot control and comparisons between centre-based, telerehabilitation and non-participants are not like-for-like. The cohort was about half the size of comparable research, which the authors say may have hidden real differences between groups. The rehabilitation nurses knew their conversations with patients were being studied, which the authors say may have changed how they spoke to patients. Information on patients' socioeconomic status was not collected, even though it has been linked to lower referral and participation. Most participants were male (84%). Patients were not asked why they chose one programme over the other, so the reasons behind choosing telerehabilitation rather than centre-based rehabilitation are unknown. This analysis reports who took part, not whether either rehabilitation programme worked; outcomes of the REHAB+ trial are reported elsewhere.
Declared interests
The authors declared that financial support was received for this work and/or its publication, with a grant from the European Institute of Innovation and Technology (grant number 210707). The telerehabilitation programme was run together with Liva, which provided the app used for remote coaching.
The easy way to misread this
Do not read this as evidence that a home telerehabilitation programme increases cardiac rehabilitation participation. The study was not built to test that, all patients were offered both options, and older patients were less likely to take part in either programme. The 20% who chose the home option might have chosen the hospital programme if it had been the only choice.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →