A Review of interventions to improve enrolment and adherence to cardiac rehabilitation among patients aged 65 years or above
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PURPOSE: This review provides an overview and quality assessment of existing interventions, assessing the intervention types that are most effective at increasing enrolment and adherence to cardiac rehabilitation in older patients aged ≥65 years Methods: The review of the literature was performed using electronic databases to search for randomised controlled trials that aimed to increase enrolment and/or adherence to cardiac rehabilitation in older patients aged ≥65 years. The main key words were cardiac rehabilitation, enrolment, adherence and older patients. Studies were included if; (1) the intervention targeted improving enrolment and/or adherence to at least one of the following components of the cardiac rehabilitation programme: exercise, education or maintaining lifestyle changes; (2) assess the effectiveness of an intervention on increasing enrolment and/or adherence to a cardiac rehabilitation programme or any of its components; (3) include measures for assessing enrolment and/or adherence to a cardiac rehabilitation programme or any of its components; (4) the study included patients with a mean age of ≥65 years who were deemed eligible to participate in a cardiac rehabilitation programme. Included studies could be published in any language and there were no date restrictions for included studies. Studies focusing on pharmaceutical adherence were not included for the purpose of this review. RESULTS: Seven studies were included, with four investigating enrolment (1944 participants) and three assessing adherence to intervention programmes (410 participants). Three studies (1919 participants) reported higher enrolment to cardiac rehabilitation in the intervention group. Two studies that reported increases in enrolment to cardiac rehabilitation were deemed to have an unclear or high risk of bias. All three studies (410 participants) reported better adherence to cardiac rehabilitation in the intervention group when compared to the control group. Two studies that reported better completion of cardiac rehabilitation were deemed to have an unclear or high risk of bias. No formal meta-analysis was conducted due to the observed multiple heterogeneity among outcome measures, the low number of included studies and variability in study designs. CONCLUSION: This review found only weak evidence to suggest that interventions can increase enrolment or adherence to cardiac rehabilitation programmes for patients aged ≥65 years, therefore no practice recommendations could be made and further high-quality research is needed in this population group.
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Exercise programs for patients with cardiovascular disease should analyze exercise barriers and facilitators before the intervention, emphasize the importance of family and peer support, exercise monitoring, and providing educational information about how to exercise in their condition.
“Exercise programs for patients with cardiovascular disease should analyze exercise barriers and facilitators before the intervention [28,35,36,37,39,40], but also, they should emphasize the importance of family and peer support [28,36,37,38,39], together with exercise monitoring [28,35,37,38] and providing educational information about how to exercise in their condition [35,36,37,38].”
From Key Factors Associated with Adherence to Physical Exercise in Patients with Chronic Diseases and Older Adults: An Umbrella Review (2021) · cites this paper as [39]
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References 43 · Cited by 23
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- [39]Norman G.R. Streiner D.L. Biostatistics: The Bare Essentials. 4th ed St Louis, MO C.V. Mosby 2014
- [40]Effective Practice and Organisation of Care (EPOC) Data collection form. EPOC Resources for review authors. Norwegian Knowledge Centre for the Health Services. 2013. Available from: http://epoc.cochrane.org/epoc-specific-resources-review-authors 2013
- [41]McPaul J. Home Visit v. Telephone Follow up in Phase II Cardiac Rehabilitation Following Myocardial Infarction [MSc dissertation]. 2007 Chester University of Chester
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- Authors
- Matata, B. M., & Williamson, S. A.
- Affiliations
- Liverpool Heart and Chest Hospital (GB)
- Corresponding author
- Matata, Bashir M.
- ORCID
- Matata, Bashir M.
- Venue
- Current Cardiology Reviews
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2017-10-23
- Volume
- 13
- Issue
- 4
- Pages
- 252-262
- ISSN
- 1573-403X (ISSN-L)
- PMC
- PMC5730958
- OpenAlex
- W2766961194
- Cited by
- 23
- References
- 43
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 3 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 3 · 2018: 2
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- cc-by-nc
- Locations
- Current Cardiology Reviews (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- cardiac rehabilitation, older adults, adherence, exercise intervention, patient education, lifestyle modification
- MeSH terms
- Cardiac Rehabilitation, Aged, Exercise Therapy, Heart Diseases, Humans, Patient Compliance, Outcome Assessment, Health Care
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