title: Comparison of uptake and predictors of adherence in primary and secondary prevention of cardiovascular disease in a community-based cardiovascular prevention programme (MyAction Westminster).
abstract: BACKGROUND
  Despite the benefits of cardiac rehabilitation, uptake and adherence remain suboptimal. With the advent of NHS Health Checks, primary prevention programmes have also been advocated, but little is known about uptake and adherence rates. This study examined rates and predictors of adherence amongst patients with cardiovascular disease (CVD) and those at high multifactorial risk (HRI) attending an innovative programme integrating primary and secondary prevention.
  
  
  METHODS
  Comparison of rates of uptake and adherence and also predictors of adherence between 401 CVD patients and 483 HRI. The outcome was the number of sessions attended and predictor variables included clinical and psychosocial variables. Differences between groups were examined using t-tests and non-parametric tests. Multivariable regression analyses examined predictors of adherence.
  
  
  RESULTS
  Uptake to the assessment (CVD: 97%, HRI: 88%) and the programme (CVD: 78%, HRI: 74%) were high for both groups. An average of 8/12 was attended in both groups. Beliefs about treatment predicted adherence for both groups (P < 0.01). The alcohol causal belief also predicted poorer adherence amongst CVD patients (P < 0.02). Older age also predicted better adherence amongst HRI (P < 0.001).
  
  
  CONCLUSIONS
  Rates of uptake and adherence were high for both HRI and CVD patients. Further research is needed to examine whether interventions targeting predictor variables further improve adherence.
authors: MyAction Westminster, Imperial College Healthcare NHS Trust, 5th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK Department of Neuropsychology and Clinical Health Psychology, 10th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
authors: Kathryn A
authors: KA
authors: Murray
authors: Department of Neuropsychology and Clinical Health Psychology, 10th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
authors: David J
authors: DJ
authors: Murphy
authors: MyAction Westminster, Imperial College Healthcare NHS Trust, 5th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
authors: Sarah-Jane
authors: SJ
authors: Clements
authors: Public Health England, London, UK.
authors: Adrian
authors: A
authors: Brown
authors: MyAction Westminster, Imperial College Healthcare NHS Trust, 5th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
authors: Susan B
authors: SB
authors: Connolly
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000517:prevention & control* / Q000523:psychology*; D003153:Community Health Services; D003863:Depression / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology* / Q000706:statistics & numerical data*; D011314:Preventive Health Services; D011322:Primary Prevention; D012044:Regression Analysis; D012189:Retrospective Studies; D055502:Secondary Prevention; D006113:United Kingdom
keywords: beliefs; population-based and preventative services; psychological determinants