The impact of patient-healthcare provider discussions on enrollment in cardiovascular
rehabilitation
Sammanfattning
OBJECTIVE: Secondary prevention programs such as cardiovascular rehabilitation significantly
decrease the burden of cardiovascular disease, yet are under-used. The most successful strategy to
promote cardiovascular rehabilitation utilization is systematic referral with a patient-provider
discussion. This study investigated: (i) the elements of patient-provider discussions related to patient
cardiovascular rehabilitation enrollment, and (ii) the frequency and correlates of these discussion
elements.
Design/PARTICIPANTS: This was a prospective study of cardiovascular patients and their healthcare
providers. Discussions about "secondary prevention" were audio-recorded. Utterances were coded
using the Roter Interaction Analysis System. Two months later, cardiovascular rehabilitation
enrollment was ascertained.
RESULTS: Discussions between 26 healthcare providers and 50 patients were recorded, of whom 27
(54.0%) enrolled in cardiovascular rehabilitation. Participants were significantly more likely to enroll
in cardiovascular rehabilitation when their healthcare providers offered less reassurance and
optimism (odds ratio (OR) = 0.81), and when the patient asked more questions related to lifestyle (OR
= 4.98). These were not common.
CONCLUSION: While caution is warranted due to the number of comparisons undertaken such that
associations observed may be chance associations, these novel findings suggest that not
overstating the beneficial effects of acute treatment, and allowing patients more time to ask questions
about needed lifestyle changes should be investigated in future research.