Why Do Patients With Ischaemic Heart Disease Drop Out From Cardiac Rehabilitation in Primary Health Settings. A Qualitative Audit of Patient Charts.
Maiken Bay Ravn, Maria Uhd, Marie Louise Svendsen and 2 others
PMID 36188975WHAT IT FOUND
Most dropouts from cardiac rehabilitation cited preferring self-administered exercise or feeling no need for care.
Logistical clashes with work and travel, plus fatigue and side effects, also drove exit. These are patient-reported reasons, not evidence that the programme fails.
Key findings
01The most common reason for dropout was a preference for self-administered training, either in a gym, at home, or at a local centre.
02Many patients did not feel they needed cardiac rehabilitation because they did not perceive themselves as sick or experiencing symptoms.
03Logistical barriers included work pressures, travel plans, and lack of flexibility, while clinical barriers included medication side effects causing fatigue.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied entirely on health professionals' notes, so the reasons for dropout reflect the clinicians' interpretation rather than the patients' own detailed perspectives. Data was missing for many referred patients; only 118 of 199 dropouts had charts with identifiable causes, potentially skewing the results. The study was conducted in Denmark where cardiac rehabilitation is integrated into primary care, which may not reflect settings where it is hospital-based or less accessible.
Declared interests
The project was funded by Public Health in the Central Denmark Region. The authors declared no commercial or financial conflicts of interest.
The easy way to misread this
Do not interpret these findings as evidence that cardiac rehabilitation is ineffective or poorly designed. The study describes why specific patients stopped attending, not whether the treatment works for those who complete it.