title: Participating or not in a cardiac rehabilitation programme: factors influencing a patient's decision.
abstract: BACKGROUND
  International research indicates that attendance of patients to a proposed cardiac rehabilitation (CR) programme varies between 21% and 75%. Addressing the reasons why cardiac patients are not participating will improve accessibility to CR. The objective of this study was to investigate patient compliance with cardiac rehabilitation and the reasons of refusing or abandoning the programme.
  
  
  METHODS
  Twenty hospital centres were recruited to participate. Each centre was asked to recruit patients from three patient groups, namely: percutaneous coronary intervention patients, patients that underwent major cardiac surgery, and patients being admitted because of an acute myocardial infarction and not belonging to the other two groups. Patients were asked to fill out a questionnaire during a follow-up outpatient consultation after the cardiac intervention.
  
  
  RESULTS
  In total, 226 patients participated in the survey. Most patients were proposed (86%) and accepted (81% out of proposed) to attend a CR programme. Of those who accepted, 77% completed the programme. The main reasons that led to patients' refusal to participate in a CR programme were distance to the CR centre, patients' belief they could handle their own problems, and lack of time. The main three reasons for not completing an initiated CR programme were other physical problems, patients' belief they could handle their own problems, and the cost of rehabilitation.
  
  
  CONCLUSIONS
  Our findings demonstrate the importance of raising patients' awareness of the benefits of CR. Addressing potential barriers to attend a CR programme should be investigated with patients individually in order to ensure compliance.
authors.affiliation: Deloitte Life Sciences and Healthcare, Brussels, Belgium. cedric_devos@hotmail.com
authors.forename: Cedric
authors.initials: C
authors.lastname: De Vos
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.forename: Ilse
authors.initials: I
authors.lastname: Van Vlaenderen
authors.forename: Omer
authors.initials: O
authors.lastname: Saka
authors.forename: Paul
authors.initials: P
authors.lastname: Dendale
authors.forename: Maria
authors.initials: M
authors.lastname: Eyssen
authors.forename: Dominique
authors.initials: D
authors.lastname: Paulus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D001530:Belgium; D006348:Cardiac Surgical Procedures; D003469:Culture; D005260:Female; D017048:Health Care Costs; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006331:Heart Diseases / Q000191:economics / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010352:Patient Dropouts; D010358:Patient Participation; D010465:Perception; D062645:Percutaneous Coronary Intervention; D045808:Refusal to Participate; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D016312:Treatment Refusal