title: Patient-Reported Outcomes in Cardiac Rehabilitation: WHAT DO WE KNOW ABOUT PROGRAM SATISFACTION? A REVIEW.
abstract: OBJECTIVE
  Patient satisfaction has become an important indicator of quality and may be related to greater adherence to cardiac rehabilitation (CR). The objectives of this narrative review were to investigate (1) patient satisfaction with CR and its relationship to adherence or health outcomes, and (2) assessment tools applicable to CR.
  
  
  METHODS
  A literature search was conducted on key resource databases, including MEDLINE, Health and Psychosocial Instruments, and Patient-Reported Outcomes and Quality of Life Instruments. A focused Internet and gray literature search was also conducted.
  
  
  RESULTS
  Eight studies were included. Patient satisfaction was high overall, especially related to education received. In 4 studies, patient satisfaction with treatment was compared in patients who attended CR with those who did not. In 2 of these studies where items were investigator generated, significant differences favoring CR were found. In the 2 studies where the treatment satisfaction subscale of the Seattle Angina Questionnaire was administered, no differences were observed. Only 1 study was identified, which examined the relationship of patient satisfaction with any outcome, and revealed that greater satisfaction was related to greater program adherence. There was a dearth of valid assessment tools.
  
  
  CONCLUSIONS
  Despite recommendations in CR association guidelines to consider patient satisfaction, there is an absence of research assessing it. The studies that have assessed it administered tools of questionable psychometric rigor. It remains to be determined whether patient satisfaction is related to any meaningful outcomes.
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada (Dr Grace and Mss Taherzadeh and Filippo); Cardiovascular Research Methods Centre, University of Ottawa Heart Institute, Ottawa, Ontario, Canada (Ms Kelly); Department of Medical Informatics, University of Amsterdam, Amsterdam, The Netherlands (Ms van Engen-Verheul); Health eResearch Centre, Institute of Population Health, University of Manchester, Manchester, England, United Kingdom (Dr Peek); and Cardiovascular Prevention and Rehabilitation, University Health Network, Toronto, Ontario, Canada (Drs Oh and Grace).
authors.forename: Golnoush
authors.initials: G
authors.lastname: Taherzadeh
authors.forename: Deandra E
authors.initials: DE
authors.lastname: Filippo
authors.forename: Shannon
authors.initials: S
authors.lastname: Kelly
authors.forename: Mariette
authors.initials: M
authors.lastname: van Engen-Verheul
authors.forename: Niels
authors.initials: N
authors.lastname: Peek
authors.forename: Paul
authors.initials: P
authors.lastname: Oh
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
mesh_terms: D000072038:Cardiac Rehabilitation / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000592:standards; D000071066:Patient Reported Outcome Measures; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires