title: The impact of patient-healthcare provider discussions on enrollment in cardiovascular rehabilitation.
abstract: OBJECTIVE
  Secondary prevention programs such as cardiovascular rehabilitation significantly decrease the burden of cardiovascular disease, yet are under-used. The most successful strategy to promote cardiovascular rehabilitation utilization is systematic referral with a patient-provider discussion. This study investigated: (i) the elements of patient-provider discussions related to patient cardiovascular rehabilitation enrollment, and (ii) the frequency and correlates of these discussion elements.
  
  
  METHODS
  This was a prospective study of cardiovascular patients and their healthcare providers. Discussions about "secondary prevention" were audio-recorded. Utterances were coded using the Roter Interaction Analysis System. Two months later, cardiovascular rehabilitation enrollment was ascertained.
  
  
  RESULTS
  Discussions between 26 healthcare providers and 50 patients were recorded, of whom 27 (54.0%) enrolled in cardiovascular rehabilitation. Participants were significantly more likely to enroll in cardiovascular rehabilitation when their healthcare providers offered less reassurance and optimism (odds ratio (OR) = 0.81), and when the patient asked more questions related to lifestyle (OR = 4.98). These were not common.
  
  
  CONCLUSIONS
  While caution is warranted due to the number of comparisons undertaken such that associations observed may be chance associations, these novel findings suggest that not overstating the beneficial effects of acute treatment, and allowing patients more time to ask questions about needed lifestyle changes should be investigated in future research.
authors.affiliation: York University, M3J 1P3 Toronto, Canada.
authors.forename: Sanam
authors.initials: S
authors.lastname: Pourhabib
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Kentner
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
mesh_terms: D000368:Aged; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011369:Professional-Patient Relations; D011446:Prospective Studies; D012017:Referral and Consultation; D055502:Secondary Prevention
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