Individual, Institutional, and Environmental Factors Promoting Patient Retention and Dropout

The primary purpose of this chapter is to determine factors that shape client dropout and adherence to Cardiac Disease Prevention and Rehabilitation Programs. The sample consists of 68 individuals, including those currently in the program (adherents) and those who have dropped out (dropouts). Findings show that clients undergoing rehabilitation are much likely to drop out when they are in the critical zone. This is a point where institutional factors, individual factors and environmentally-related factors are not favorable to clients. The risk of clients dropping out can be drastically reduced through the provision of an enabling environment comprising a set of factors that foster adherence such as financial sponsorship, institutional support, high intrinsic motivation, improved illness perception. In that context, there is the need for program administrators to closely monitor at-risk clients, especially those whose social, economic and psychological profiles predict non-adherence.