Use of cardiac rehab increased by automatic referral plus patient discussion
MedWire News: Results from a Canadian study indicate that the use of cardiac rehabilitation (CR) services by patients with coronary artery disease (CAD) may be increased more than eight-fold if a system of automatic referral followed by patient-clinician discussion is implemented.
"This combination of strategies may be most effective because it targets the healthcare provider and patient," explain the authors.
The "electronic record prompts the referral, and the patient discussion ensures healthcare provider endorsement and clarifies any misconceptions or barriers patients may have about CR."
Sherry Grace, from York University in Toronto, Ontario, and colleagues, assessed the rates of CR uptake among 2635 CAD patients referred via one of four referral strategies: combined automatic and liaison (defined as patient-clinician discussion) referral, automatic referral only, liaison referral only, and usual referral at the discretion of the healthcare provider.
At the end of a 1-year follow-up period, all patients were given questionnaires to self-report the percentage of prescribed CR sessions they attended. However, only 1809 (69%) patients completed the questionnaire, reporting a mean attendance of 82.9%.
As reported in the Archives of Internal Medicine, all modes of referral increased the rate of CR use compared with usual referral. The most effective method was combined automatic and liaison referral, which increased CR use 8.41-fold compared with usual referral.
Liaison-only and automatic-only referral produced similar increases in CR use of 3.35- and 3.27-fold, respectively, compared with usual referral.
"While wider adoption of these CR referral strategies would potentially improve the health of many patients being treated for cardiac disease, new funding and service delivery models should be explored to mitigate effects on capacity and wait times," conclude Grace and team.
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By Lauretta Ihonor