Education of Physicians and Implementation of a Formal Referral System Can Improve Cardiac Rehabilitation Referral and Participation Rates after Percutaneous Coronary Intervention
Education of Physicians and Implementation of a Formal Referral System Can Improve Cardiac Rehabilitation Referral and Participation Rates after Percutaneous Coronary Intervention
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DOI：
10.1016/j.hlc.2015.02.006
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发表时间：
2015-08-01
影响因子：
2.6
通讯作者：
Sharma, Gyanendra K.
中科院分区：
文献类型：
--
作者：
Dahhan, Ali;Maddox, William R.;Sharma, Gyanendra K.
背景心脏康复（CR）是一种有效的预防措施，但在美国尚未得到充分利用。该研究旨在确定学术三级护理中心经皮冠状动脉介入治疗（PCI）后的CR转诊率（RR），确定转诊障碍，并评估心脏病专家对CR益处和适应症（CRBI）的认识。随后，它的目的是评估，如果一个干预措施，包括医生的教育CRBI和实施正式的CR转诊系统，可以提高RR，从而参与率（PR）。确定转诊率，并比较转诊和非转诊患者之间的差异。在心脏病科的医生中分发调查问卷，以评估CRBI的认识和转诊实践模式。实施干预措施后，回顾性收集在接下来的六个月内接受PCI的连续患者的数据。结果干预前，RR为17.6%。不同的障碍被确定，但调查问卷显示，缺乏医生的认识CRBI和不一致的转诊模式。干预后RR上升至88.96%（OR 37.73，95%CI 21.34-66.70，p
Background Cardiac rehabilitation (CR) is an effective preventive measure that remains underutilised in the United States. The study aimed to determine the CR referral rate (RR) after percutaneous coronary intervention (PCI) at an academic tertiary care centre, identify barriers to referral, and evaluate awareness of CR benefits and indications (CRBI) among cardiologists. Subsequently, it aimed to evaluate if an intervention consisting of physicians' education about CRBI and implementation of a formal CR referral system could improve RR and consequently participation rate (PR).Methods Data were retrospectively collected for all consecutive patients who underwent PCI over 12 months. Referral rate was determined and variables were compared for differences between referred and nonreferred patients. A questionnaire was distributed among the physicians in the Division of Cardiology to assess awareness of CRBI and referral practice patterns.After implementation of the intervention, data were collected retrospectively for consecutive patients who underwent PCI in the following six months. Referral rate and changes in PRs were determined.Results Prior to the intervention, RR was 17.6%. Different barriers were identified, but the questionnaire revealed lack of physicians' awareness of CRBI and inconsistent referral patterns. After the intervention, RR increased to 88.96% (Odds Ratio 37.73, 95% CI 21.34-66.70, p