Intention and change in intention predict attendance at Cardiac Rehabilitation

Abstract

Background: Cardiac rehabilitation (CR) is effective in promoting physical and psychological recovery following acute cardiac syndrome (ACS). Only 42% of eligible patients attend in the UK. This study examines determinants of attendance at Phase 3 CR in a cohort of ACS patients followed from discharge until the start of CR. Methods: Of 488 eligible ACS patients (March 2012 to July 2013), 214 consented. Consecutive patients completed a questionnaire pre-discharge targeting age, diagnosis, social class and smoking history. A computerised weekly diary measured intention to attend thereafter. A multi-level structural equation model (aML software) combined a basic growth model for intention and logistic model for attendance. Intention was reflected and log transformed (intention reflected-log). Findings: 169 participants provided 5 weeks of diary entries on average. The intercept for intention reflected-log (t=-2.92, p<.005), and slope for intention reflected-log t (t=-2.08, p=.04) predicted attendance. Control for demographic variables reduced the slope effect (t=-1.57, p=.12). The least deprived participants were more likely to attend than the most (t=2.14, p<.03). Conclusions: High intention following discharge, and low decline in intention predicts attendance at CR.