Factors Associated With Failure to Complete Phase II Cardiac Rehabilitation: Survey Registry in Rajaie Cardiovascular Medical and Research Center

Background: A significant proportion of patients who begin CR (cardiac rehabilitation) do not complete the program.

Objectives: The purpose of this study was to determine the predicting factors that interfere with adherence and completion of an outpatient CR program.

Patients and Methods: A cross-sectional survey was conducted with all 128 patients who entered the CR program at the Rajaie Cardiovascular Medical and Research Center in Tehran, IR Iran, from March 2009 to March 2010. The demographic variables included age, sex, education, employment status, insurance status, and return to work. These variables were compared in patients who completed and did not complete phase II CR. The reason for CR incompletion was asked in follow-up phone interviews.

Results: The most frequent clinical diagnosis among the patients enrolled in the CR program was coronary artery disease. 83.6% of patients who participated had a CABG or PCI procedure during the last year. CR participation increased when cardiac revascularization procedures were performed during the first hospitalization. 88 of the 128 patients dropped out, yielding a dropout rate of 68.7%, which was significantly (P < 0.01) higher than the same study in other countries. Sex and age did not predict the completion rate. As education increased, cardiac rehabilitation utilization and completion increased. Unemployed patients were less likely than employed patients to complete the program.

Conclusions: Our data indicate a low rate of CR completion, with lower rates among unemployed, uninsured, and less educated patients.