Understanding attendance patterns and determinants in cardiac, pulmonary, and ICU rehabilitation/recovery programs: A systematic review and meta-analysis.
Leanne M Boehm, Kelly Potter, Joanne McPeake and 9 others
PMID 39307001WHAT IT FOUND
Across studies, 54% of referred patients attended cardiac, pulmonary, or ICU recovery programs at least once, but rates ranged from 3.7% to 94.8%.
Transportation, cost, work conflicts, and little program contact were barriers. Provider recommendation and flexible scheduling were facilitators.
Key findings
01Attendance ranged from 3.7% to 94.8% across studies, and combined rates were 53% for cardiac rehabilitation, 56% for pulmonary rehabilitation, and 61% for ICU recovery programs.
02Cardiac rehabilitation attendance was lower in Asia, Australia/New Zealand, and North America than in Europe, while pulmonary and ICU recovery attendance did not differ significantly across international settings.
03High attendance programs had at least 3 of 4 referrals attending, and 31.5% reported remote or hybrid delivery, while low attendance programs averaged 1 of 4 referrals attending and 8.6% reported remote or hybrid delivery.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The review did not check the quality of the included studies, so weak studies may have influenced the attendance estimates. It only included studies that reported referred patients, not all eligible patients, so the rates may not apply to patients who were never referred. Attendance meant at least one visit, not whether patients kept attending, so it does not show long-term adherence. Study rates varied from 3.7% to 94.8% and heterogeneity was very high, so one average does not predict a local program. The search was limited to English-language publications, so programs in other languages may be missing. Barriers and facilitators were grouped from what studies reported, not measured or quantified, so their relative importance is unclear. Program types and delivery models differed, so direct comparisons between cardiac, pulmonary, and ICU recovery programs are not robust.
The easy way to misread this
Do not assume that remote or hybrid delivery will increase attendance. High attendance programs reported remote or hybrid delivery more often than low attendance programs, but the review did not test whether delivery method caused the difference.