Evidence map›Paper›PMID 38631370›Full record

ArticleClinical rehabilitation2024

Clinical effectiveness of cardiac rehabilitation and barriers to completion in patients of low socioeconomic status in rural areas: A mixed-methods study.

Alline Beleigoli, Hila Ariela Dafny, Maria Alejandra Pinero de Plaza, Claire Hutchinson, Tania Marin, Joyce S Ramos, Orathai Suebkinorn, Lemlem G Gebremichael, Norma B Bulamu, Wendy Keech and 4 more

Abstract read
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In one paragraph

Article in Clinical rehabilitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Alline BeleigoliCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.ORCID 0000-0002-7848-3183
Hila Ariela DafnyCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Maria Alejandra Pinero de PlazaCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.ORCID 0000-0001-5421-9604
Claire HutchinsonCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Tania MarinCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Joyce S RamosCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Orathai SuebkinornCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Lemlem G GebremichaelCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Norma B BulamuFlinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia.
Wendy KeechHealth Translation SA, Adelaide, Australia.
Marie LudlowHeart Foundation of Australia, Adelaide, Australia.
Jeroen HendriksCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.
Vincent VersaceDeakin Rural Health, Deakin University, Burwood, Australia.
Robyn A ClarkCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate cardiac rehabilitation utilisation and effectiveness, factors, needs and barriers associated with non-completion.

designWe used the mixed-methods design with concurrent triangulation of a retrospective cohort and a qualitative study.

settingEconomically disadvantaged areas in rural Australia.

participantsPatients (≥18 years) referred to cardiac rehabilitation through a central referral system and living in rural areas of low socioeconomic status. MAIN MEASURES: A Cox survival model balanced by inverse probability weighting was used to assess the association between cardiac rehabilitation utilization and 12-month mortality/cardiovascular readmissions. Associations with non-completion were tested by logistic regression. Barriers and needs to cardiac rehabilitation completion were investigated through a thematic analysis of semi-structured interviews and focus groups (n = 28).

resultsAmong 16,159 eligible separations, 44.3% were referred, and 11.2% completed cardiac rehabilitation. Completing programme (HR 0.65; 95%CI 0.57-0.74; p < 0.001) led to a lower risk of cardiovascular readmission/death. Living alone (OR 1.38; 95%CI 1.00-1.89; p = 0.048), having diabetes (OR 1.48; 95%CI 1.02-2.13; p = 0.037), or having depression (OR 1.54; 95%CI 1.14-2.08; p = 0.005), were associated with a higher risk of non-completion whereas enrolment in a telehealth programme was associated with a lower risk of non-completion (OR 0.26; 95%CI 0.18-0.38; p < 0.001). Themes related to logistic issues, social support, transition of care challenges, lack of care integration, and of person-centeredness emerged as barriers to completion.

conclusionsCardiac rehabilitation completion was low but effective in reducing mortality/cardiovascular readmissions. Understanding and addressing barriers and needs through mixed methods can help tailor cardiac rehabilitation programmes to vulnerable populations and improve completion and outcomes.

Indexed as

Cardiac RehabilitationRural PopulationAgedAustraliaFemaleHealth Services AccessibilityHumansLow Socioeconomic StatusMaleMiddle AgedPatient ComplianceQualitative ResearchRetrospective StudiesSocial Classcardiac rehabilitationCardiovascular diseaselow socioeconomic statusmorbidity and mortalityrural populations

Identifiers

PMID38631370
PMCPMC11059835

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.