Factors predicting discontinuation of a hospital-based cardiac rehabilitation programme

Background: Cardiac rehabilitation (CR) programmes play an important role in the management of patients with coronary artery disease. However, a significant proportion of patients do not participate or do not complete CR. Aim: To asses the prevalence and predictors of discontinuation of a hospital-based CR programme and to investigate whether or not the completers and dropouts differed in relation to their baseline characteristics. Methods: Data used for analysis were from a hospital-based CR programme involving 1986 discharged patients at Tehran Heart Centre between July 2004 and January 2006. The patients who completed all 24 sessions of the CR programme were compared with the dropouts. Results: The CR completion rate was 18.1% (average of 11.4 +/- 8.1, ranging from 1 to 78 sessions) including patients who completed 24 (n=284) or more sessions (n=77) of the CR programme. Factors predicting dropout were male gender (OR 1,441, p=0.0094), younger age (OR 0.979, p=0.005), and lower levels of education (OR 0.412, p <0.0001). Conclusion: The present study demonstrated a relatively high rate of CR programme dropout. Only less than a fifth of the patients completed this hospital-based programme. Patients who were male and younger and had lower education levels were better likely to drop out of the CR programme. Social support and educational programmes may be helpful in achieving better compliance.