Academic Journal
Clinical effectiveness of cardiac rehabilitation and barriers to completion in patients of low socioeconomic status in rural areas: A mixed-methods study
| العنوان: | Clinical effectiveness of cardiac rehabilitation and barriers to completion in patients of low socioeconomic status in rural areas: A mixed-methods study |
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| المؤلفون: | Alline Beleigoli, Hila Ariela Dafny, Maria Alejandra Pinero de Plaza, Claire Hutchinson, Tania Marin, Joyce S Ramos, Orathai Suebkinorn, Lemlem G Gebremichael, Norma B Bulamu, Wendy Keech, Marie Ludlow, Jeroen Hendriks, Vincent Versace, Robyn A Clark |
| سنة النشر: | 2024 |
| مصطلحات موضوعية: | Biomedical and clinical sciences, Clinical sciences, Health sciences, Health services and systems, Public health, cardiac rehabilitation, Cardiovascular disease, low socioeconomic status, morbidity and mortality, rural populations |
| الوصف: | Objective To investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion. Design We used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study. Setting Economically disadvantaged areas in rural Australia. Participants Patients (≥18 years) referred to cardiac rehabilitation through a central referral system and living in rural areas of low socioeconomic status. Main measures A Cox survival model balanced by inverse probability weighting was used to assess the association between cardiac rehabilitation utilization and 12-month mortality/cardiovascular readmissions. Associations with non-completion were tested by logistic regression. Barriers and needs to cardiac rehabilitation completion were investigated through a thematic analysis of semi-structured interviews and focus groups (n = 28). Results Among 16,159 eligible separations, 44.3% were referred, and 11.2% completed cardiac rehabilitation. Completing programme (HR 0.65; 95%CI 0.57–0.74; p < 0.001) led to a lower risk of cardiovascular readmission/death. Living alone (OR 1.38; 95%CI 1.00–1.89; p = 0.048), having diabetes (OR 1.48; 95%CI 1.02–2.13; p = 0.037), or having depression (OR 1.54; 95%CI 1.14–2.08; p = 0.005), were associated with a higher risk of non-completion whereas enrolment in a telehealth programme was associated with a lower risk of non-completion (OR 0.26; 95%CI 0.18–0.38; p < 0.001). Themes related to logistic issues, social support, transition of care challenges, lack of care integration, and of person-centeredness emerged as barriers to completion. Conclusions Cardiac rehabilitation completion was low but effective in reducing mortality/cardiovascular readmissions. Understanding and addressing barriers and needs through mixed methods can help tailor cardiac rehabilitation programmes to vulnerable populations and improve completion and outcomes. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | unknown |
| Relation: | http://hdl.handle.net/10779/DRO/DU:26367421.v1 |
| الاتاحة: | http://hdl.handle.net/10779/DRO/DU:26367421.v1 https://figshare.com/articles/journal_contribution/Clinical_effectiveness_of_cardiac_rehabilitation_and_barriers_to_completion_in_patients_of_low_socioeconomic_status_in_rural_areas_A_mixed-methods_study/26367421 |
| Rights: | All Rights Reserved |
| رقم الانضمام: | edsbas.3A194434 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |