Risk for Re-Enrollment to Cardiac Rehabilitation: A Retrospective Study of Ontario-Based Cardiac Rehabilitation Programs

Date of Award

1-10-2023

Publication Type

Thesis

Degree Name

M.H.K.

Department

Kinesiology

Keywords

Cardiac rehabilitation program, Cardiovascular disease, Ontario CR program, Quality of life

Supervisor

C.McGowan

Supervisor

K.Milne

Abstract

Cardiac rehabilitation (CR) reduces recurrent cardiac events, and cardiovascular disease-related mortality, and increases overall quality of life among individuals with heart disease. Some participants have recurrent cardiac events and require re-referral to CR; however, it is not known whether the risk for recurrent events can be predicted and possibly mitigated. Thus, the purpose of this study was to describe CR re-referral and subsequent re-enrollment rates and understand the impact of risk factors on the risk of re-enrollment. In this study, data from individuals who were referred to CR (n = 1602) in 2008 and individuals who enrolled (n = 930) at two Southwestern Ontario CR programs over a five-year period were used. CR re-referral was defined as a second event within five years of initial discharge in 2008 that may or may not have resulted in re-enrollment, whereas re-enrollment was defined as a second admission to CR. Time to re-referral and re-enrollment by hospital site was described using the Kaplan Meier method and log-rank test. Of the 930 participants who enrolled (58% of individuals referred to CR), 27 (2.9%) participated in CR a second time. The time of re-enrollment was not influenced significantly by program site (Mean (M)=4.89 years, 95% CI 4.84 - 4.95, p =.75 and M=4.92 years, 95% CI 4.87 - 4.97). Findings suggest that individuals who participate in CR the first time have a low rate of re-enrollment and that Ontario CR programs have a consistent model of care.

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