Predicting attendance at cardiac rehabilitation: a review and recommendations

Abstract

Attending a cardiac rehabilitation programme is of proven benefit to those recovering from a myocardial infarction, resulting in a reduction of risk factors, distress, morbidity and mortality. But despite proven benefits, uptake of services can be low. To understand why attendance can be low, there is a growing body of research investigating factors that may influence and predict attendance. These research studies, which have found various factors such as age, gender, social deprivation and distance from a programme to influence attendance, will be reviewed. Given that sociodemographic and medical factors influence attendance, recent research has focused on investigating the role of factors which may be more amenable to change. These studies have found that psychological factors, such as the way a patient understands their illness, influence attendance. Psychological models such Leventhal's Self-regulatory Model and The Theory of Planned Behaviour have been used to guide this research. Each of these models will be presented here in relation to cardiac rehabilitation (CR), in addition to the research studies which have investigated their usefulness in predicting who attends CR. Research implications for service provision will be discussed and recommendations for increasing attendance will be presented.