title: Factors associated with enrollment and adherence in outpatient cardiac rehabilitation in Japan.
abstract: OBJECTIVE
  Despite the effectiveness of cardiac rehabilitation (CR), the participation percentage is low in Japan. Therefore, we investigated factors associated with enrollment and adherence in outpatient cardiac rehabilitation (OCR) in Japan.
  
  
  METHODS
  This was a single-hospital, case-controlled study. During a 2-year study period, 544 patients were hospitalized for ischemic heart disease, heart failure, or open heart surgery, and recommended for in-hospital CR. Among them, 78 OCR participants and 179 randomly selected nonparticipants were included in the study. These 2 groups were compared to examine factors associated with OCR enrollment. In addition, OCR participants were divided into those who continued OCR for 3 months (adherence group) and those who did not (nonadherence group), and these 2 groups were compared to examine factors associated with OCR adherence. Univariate and multivariate logistic regression analyses were conducted for both objectives and included sociodemographic, clinical, and OCR-related variables.
  
  
  RESULTS
  OCR enrollment was significantly associated with younger age (OR, 0.96; 95% CI, 0.93-0.98) and shorter distance to the hospital (OR, 0.97; 95% CI, 0.95-0.99). OCR adherence was significantly associated with a history of ischemic heart disease (OR, 6.03; 95% CI, 1.62-22.5) and prescription of antidepressants and/or sleeping pills (OR, 4.14; 95% CI, 1.07-16.0).
  
  
  CONCLUSIONS
  The main factors associated with OCR enrollment and adherence were sociodemographic factors related to easier hospital access and clinical conditions that reflected high disease awareness, respectively.
authors.affiliation: Department of Public Health, Fukushima Medical University School of Medicine (Drs Endo, Goto, Suzuki, and Yasumura), and Ohta-Nishinouchi Hospital, Ohta General Hospital Foundation (Drs Endo and Matsuda), Nishinouchi Koriyama, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Endo
authors.forename: Aya
authors.initials: A
authors.lastname: Goto
authors.forename: Tomoko
authors.initials: T
authors.lastname: Suzuki
authors.forename: Shin
authors.initials: S
authors.lastname: Matsuda
authors.forename: Seiji
authors.initials: S
authors.lastname: Yasumura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006331:Heart Diseases / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data*; D055815:Young Adult