Patient perspectives on barriers to participate in cardiac rehabilitation

Abstract

BACKGROUND: Despite proven benefits of cardiac rehabilitation (CR), patients' attendance at cardiac rehabilitation program (CRP) is poor at National hospital of Sri Lanka (NHSL). OBJECTIVES: To identify patient perspectives of barriers to participate in cardiac rehabilitation program at NHSL. METHODS: A cross sectional study was conducted at cardiothoracic outpatient clinics of the National Hospital of Sri Lanka from May to July 2019. Post cardiac surgery patients who were referred to CRP but not attending them were studied. Data were collected using an interviewer administrated questionnaire and was analyzed with SPSS-version20. RESULTS: A total of 80 patients not attending CRP (male 41 (51.3%), mean age 59±11.7years, range 29-78 years) were studied. 87.5% of them were married, 46.3% had an income below Rs. 30,000/month, 51(63.7%) had studied up to grade- I 0 and 48(60%) were travelling from more than 50km.28(35%) patients were unaware of them being referred to CRP and its detail while 32(40%) were unaware of benefit of participation in CRP. The main reasons pointed by patients for not participating in CRP were difficulty in attending clinics due to distance and transportation issues 29(36.3%), other co-morbid medical issues 9(11.3%), non-availability of CRP nearby-29(36.3%) and not having proper guidance/advice at discharge-17(21.5%). CONCLUSION: Limited availability of CRP and unsatisfactory education of patients on the importance of CR at discharge following cardiac surgery were the main factors for poor attendance at CRP. Therefore, in­ cooperating a 'Patient education program' in the cardiac surgery protocol of and establishing new CRP in peripheries need priority to maximize the use of cardiac rehabilitation in Sri Lanka.