title: Patient Characteristics Predictive of Cardiac Rehabilitation Adherence.
abstract: OBJECTIVE
  Cardiac rehabilitation (CR) is a program of structured exercise and interventions for coronary risk factor reduction that reduces morbidity and mortality rates following a major cardiac event. Although a dose-response relationship between the number of CR sessions completed and health outcomes has been demonstrated, adherence with CR is not high. In this study, we examined associations between the number of sessions completed within CR and patient demographics, clinical characteristics, smoking status, and socioeconomic status (SES).
  
  
  METHODS
  Multiple logistic regression and classification and regression tree (CART) modeling were used to examine associations between participant characteristics measured at CR intake and the number of sessions completed in a prospectively collected CR clinical database (n = 1658).
  
  
  RESULTS
  Current smoking, lower SES, nonsurgical diagnosis, exercise-limiting comorbidities, and lower age independently predicted fewer sessions completed. The CART analysis illustrates how combinations of these characteristics (ie, risk profiles) predict the number of sessions completed. Those with the highest-risk profile for nonadherence (<65 years old, current smoker, lower SES) completed on average 9 sessions while those with the lowest-risk profile (>72 years old, not current smoker, higher SES, surgical diagnosis) completed 27 sessions on average.
  
  
  CONCLUSIONS
  Younger individuals, as well as those who report smoking or economic challenges or have a nonsurgical diagnosis, may require additional support to maintain CR session attendance.
authors.affiliation: Vermont Center on Behavior and Health, Burlington (Drs Gaalema, Higgins, and Ades, Mr Cutler, and Ms Elliott); Departments of Psychiatry (Drs Gaalema and Higgins, Mr Cutler, and Ms Elliott), Psychology (Drs Gaalema and Higgins), and Medical Biostatistics (Mr Savage and Rengo and Dr Ades), University of Vermont, Burlington; and Department of Medicine, University of Vermont Medical Center, Burlington (Dr Priest).
authors.forename: Diann E
authors.initials: DE
authors.lastname: Gaalema
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Savage
authors.forename: Jason L
authors.initials: JL
authors.lastname: Rengo
authors.forename: Alex Y
authors.initials: AY
authors.lastname: Cutler
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Elliott
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Priest
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Higgins
authors.forename: Philip A
authors.initials: PA
authors.lastname: Ades
mesh_terms: D000367:Age Factors; D000072038:Cardiac Rehabilitation / Q000706:statistics & numerical data*; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014707:Vermont / Q000453:epidemiology