Curriculum in CardiologyDeterminants of referral to cardiac rehabilitation programs in patients with coronary artery disease: A systematic review
Section snippets
Identification of relevant studies
Studies were identified by searching the following electronic databases: MEDLINE (1966-2003), CINAHL (1982-2003), HealthSTAR (1975-2003), EMBASE (1966-2003), and The Cochrane Library Controlled Trials Registry. For studies on referral of patients with CAD, the search terms combined were “myocardial infarction,” “acute myocardial infarction,” “coronary artery disease,” with “rehabilitation,” “cardiac rehabilitation,” “referral,” or “consultation.” Search terms such as “secondary prevention” and
General characteristics of the studies
All 10 included studies were observational (Table I), including 10 487 referrals among 30 333 patients with CAD. Nine cohort studies (6 prospective and 3 retrospective) and one cross-sectional study, published between 1999 and 2004, were assessed. Five studies were conducted in the United States, 3 in Canada, and 2 in Australia. Most studies sought to answer questions on determinants of referral to CR after acute MI.15, 26, 27, 28, 29, 30
Quality assessment of studies on referral
The quality of the studies was assessed according to the
Discussion
This systematic review suggests that referral to CR is an example of a treatment gap in the secondary prevention of CAD. Furthermore, the review identified 3 domains in which referral disparities can be found; these are sociodemographic factors, health status factors, and health care system factors. Although the data did not allow the advantages of statistical pooling, there was sufficient consistency across studies to permit clustering of the individual factors. Because of study design
References (38)
- et al.
Effects of exercise and cardiac rehabilitation on cardiovascular outcomes
Cardiol Clin
(2003) - et al.
Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials
Am J Med
(2004) - et al.
Effect of intravenous nitrates on mortality in acute myocardial infarction: an overview of the randomised trials
Lancet
(1988) - et al.
Referral patterns and exercise response in the rehabilitation of female coronary patients aged greater than or equal to 62 years
Am J Cardiol
(1992) - et al.
Cardiac rehabilitation II: referral and participation
Gen Hosp Psychiatry
(2002) - et al.
1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction)
J Am Coll Cardiol
(1999) - et al.
Cardiac rehabilitation for community-based patients with myocardial infarction: factors predicting discharge recommendation and participation
J Clin Epidemiol
(2001) - et al.
Self-reported cardiovascular disease and risk factors. Prevalence in Ontario among women 50 and older
Can Fam Physician
(1997) The world health report 1997
- et al.
Revascularization and heart attack outcomes
Health Rep
(2002)
Exercise-based rehabilitation for coronary heart disease
Cochrane Database Syst Rev
An overview of randomized trials of rehabilitation with exercise after myocardial infarction
Circulation
Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trails
JAMA
Exercise-based cardiac rehabilitation programs for coronary artery disease: a systematic clinical and economic review
Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review
Prog Cardiovasc Nurs
Utilisation of outpatient cardiac rehabilitation in Queensland
Med J Aust
The Ontario cardiac rehabilitation pilot project-report and recommendations
A meta-analysis of psychoeducational programs for coronary heart disease patients
Health Psychol
Long-term reduction of cardiac mortality after myocardial infarction: 10-year results of a comprehensive rehabilitation programme
Eur Heart J
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