Extended cardiac rehabilitation for socially vulnerable patients improves attendance and outcome.
Abstract INTRODUCTION: Patients living alone or having a low socioeconomic status are likely to quit cardiac rehabilitation. We aimed to compare patients being offered extended rehabilitation (ERP) with those being offered standard rehabilitation (SRP) as concerns 1) attendance rates and 2) achievement of treatment goals at 12 months. MATERIAL AND METHODS: During a five-year period, 508 consecutive myocardial infarction patients below the age of 70 years were included. In the first two years of the study, 205 patients were offered SRP (historic controls); during the last three years of the study, 303 patients were identified of whom socially non-vulnerable patients were assigned to SRP and socially vulnerable patients were assigned to ERP. RESULTS: Socially vulnerable patients achieved significantly higher participation rates (97.7%) than controls (75.0%), p < 0.0001, if they were offered ERP. There was no difference in cardiac rehabilitation attendance rate among socially non-vulnerable patients compared to controls (84.7% versus 82.1, p = 0.64). Socially vulnerable patients being offered ERP also had lower levels of cholesterol, systolic blood pressure and body mass index, and a higher level of compliance with medication than controls. CONCLUSION: Extended offers for socially vulnerable patients improve attendance rates for cardiac rehabilitation and seem to improve the share of patients achieving treatment goals. FUNDING: The Ministry of the Interior and Health, the Ministry of Social Affairs in Denmark, The Danish Heart Foundation and Aarhus University Hospital Research Initiative funded the present study. TRIAL REGISTRATION: not relevant.