Factors influencing active participation in cardiac rehabilitation among patients with cardiovascular disease: A nationwide cohort study.

Background: Cardiac rehabilitation (CR) is a well-established program for improving exercise capacity, quality of life, and long-term outcomes in patients with cardiovascular disease (CVD). Despite its proven benefits, CR participation rates remain low in many countries. Identifying the barriers to CR participation is crucial for developing effective strategies to enhance patient engagement in these programs.

Objective: To analyze the barriers to CR participation among patients with CVD. To analyze the barriers to cardiac rehabilitation (CR) participation among patients with cardiovascular disease (CVD).

Design: A nationwide cohort study using data from the Korean National Health Insurance Database.

Setting: South Korea.

Patients: In 2019, patients who received coronary revascularization at hospitals operating CR program.

Interventions: Comparison of the demographic, socioeconomic, and medical status between patients who actively participated in CR and those who did not.

Main outcome measures: The analysis considered potential influencing factors such as gender, age, residence area, income level, disability status, medical comorbidities, accompanying disease, cigarette smoking, alcohol consumption, physical activity levels, and obesity.

Results: The CR participation rate was low among women, older adults, rural residents, and low-income families. In addition, the participation rate was low when there was a disability or medical comorbidity, such as hypertension, diabetes, and musculoskeletal disorders. CR participation rate was also low in patients who experienced CVD recurrence within 10 years.

Conclusion: CR participation is affected by medical comorbidities, in addition to gender, age, income level, and residence. In particular, participation rate is lower in patients with a high risk of CVD recurrence due to medical comorbidities.