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Meta-Analysis
. 2019 Feb 1;2(2):CD007131.
doi: 10.1002/14651858.CD007131.pub4.

Interventions to promote patient utilisation of cardiac rehabilitation

Carolina Santiago de Araújo Pio  1 , Gabriela Ss Chaves, Philippa Davies, Rod S Taylor, Sherry L Grace
Affiliations
Meta-Analysis

Interventions to promote patient utilisation of cardiac rehabilitation

Carolina Santiago de Araújo Pio et al. Cochrane Database Syst Rev. .

Abstract

Background: International clinical practice guidelines routinely recommend that cardiac patients participate in rehabilitation programmes for comprehensive secondary prevention. However, data show that only a small proportion of these patients utilise rehabilitation.

Objectives: First, to assess interventions provided to increase patient enrolment in, adherence to, and completion of cardiac rehabilitation. Second, to assess intervention costs and associated harms, as well as interventions intended to promote equitable CR utilisation in vulnerable patient subpopulations.

Search methods: Review authors performed a search on 10 July 2018, to identify studies published since publication of the previous systematic review. We searched the Cochrane Central Register of Controlled Trials (CENTRAL); the National Health Service (NHS) Centre for Reviews and Dissemination (CRD) databases (Health Technology Assessment (HTA) and Database of Abstracts of Reviews of Effects (DARE)), in the Cochrane Library (Wiley); MEDLINE (Ovid); Embase (Elsevier); the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCOhost); and Conference Proceedings Citation Index - Science (CPCI-S) on Web of Science (Clarivate Analytics). We checked the reference lists of relevant systematic reviews for additional studies and also searched two clinical trial registers. We applied no language restrictions.

Selection criteria: We included randomised controlled trials (RCTs) in adults with myocardial infarction, with angina, undergoing coronary artery bypass graft surgery or percutaneous coronary intervention, or with heart failure who were eligible for cardiac rehabilitation. Interventions had to aim to increase utilisation of comprehensive phase II cardiac rehabilitation. We included only studies that measured one or more of our primary outcomes. Secondary outcomes were harms and costs, and we focused on equity.

Data collection and analysis: Two review authors independently screened the titles and abstracts of all identified references for eligibility, and we obtained full papers of potentially relevant trials. Two review authors independently considered these trials for inclusion, assessed included studies for risk of bias, and extracted trial data independently. We resolved disagreements through consultation with a third review author. We performed random-effects meta-regression for each outcome and explored prespecified study characteristics.

Main results: Overall, we included 26 studies with 5299 participants (29 comparisons). Participants were primarily male (64.2%). Ten (38.5%) studies included patients with heart failure. We assessed most studies as having low or unclear risk of bias. Sixteen studies (3164 participants) reported interventions to improve enrolment in cardiac rehabilitation, 11 studies (2319 participants) reported interventions to improve adherence to cardiac rehabilitation, and seven studies (1567 participants) reported interventions to increase programme completion. Researchers tested a variety of interventions to increase utilisation of cardiac rehabilitation. In many studies, this consisted of contacts made by a healthcare provider during or shortly after an acute care hospitalisation.Low-quality evidence shows an effect of interventions on increasing programme enrolment (19 comparisons; risk ratio (RR) 1.27, 95% confidence interval (CI) 1.13 to 1.42). Meta-regression revealed that the intervention deliverer (nurse or allied healthcare provider; P = 0.02) and the delivery format (face-to-face; P = 0.01) were influential in increasing enrolment. Low-quality evidence shows interventions to increase adherence were effective (nine comparisons; standardised mean difference (SMD) 0.38, 95% CI 0.20 to 0.55), particularly when they were delivered remotely, such as in home-based programs (SMD 0.56, 95% CI 0.37 to 0.76). Moderate-quality evidence shows interventions to increase programme completion were also effective (eight comparisons; RR 1.13, 95% CI 1.02 to 1.25), but those applied in multi-centre studies were less effective than those given in single-centre studies, leading to questions regarding generalisability. A moderate level of statistical heterogeneity across intervention studies reflects heterogeneity in intervention approaches. There was no evidence of small-study bias for enrolment (insufficient studies to test for this in the other outcomes).With regard to secondary outcomes, no studies reported on harms associated with the interventions. Only two studies reported costs. In terms of equity, trialists tested interventions designed to improve utilisation among women and older patients. Evidence is insufficient for quantitative assessment of whether women-tailored programmes were associated with increased utilisation, and studies that assess motivating women are needed. For older participants, again while quantitative assessment could not be undertaken, peer navigation may improve enrolment.

Authors' conclusions: Interventions may increase cardiac rehabilitation enrolment, adherence and completion; however the quality of evidence was low to moderate due to heterogeneity of the interventions used, among other factors. Effects on enrolment were larger in studies targeting healthcare providers, training nurses, or allied healthcare providers to intervene face-to-face; effects on adherence were larger in studies that tested remote interventions. More research is needed, particularly to discover the best ways to increase programme completion.

PubMed Disclaimer

Conflict of interest statement

CSAP: none known.

GSSC: none known.

PD: none known.

RST: currently a co‐author of several other Cochrane Reviews on cardiac rehabilitation. He is Chief Investigator in receipt of ongoing National Institute of Health Research Programme Grants for Applied Research (RP‐PG‐1210‐12004): Rehabilitation Enablement in Chronic Heart Failure (REACH‐HF). He was involved in some of the included trials, but was not involved in the RoB or GRADE assessment related to these studies.

SLG: Was principal investigator of an included trial, but did not do the RoB or GRADE assessment relating to the trial.

Figures

1
1
Flow diagram of the study selection process for this update.
2
2
Methodological quality graph: review authors' judgments about each risk of bias element presented as percentages across all included studies.
3
3
Methodological quality summary: review authors' judgments about each risk of bias item for each included study.
4
4
Funnel plot of comparison: 1 CR utilisation, outcome: 1.1 Enrolment.
1.1
1.1. Analysis
Comparison 1 CR utilisation, Outcome 1 Enrolment.
1.2
1.2. Analysis
Comparison 1 CR utilisation, Outcome 2 Enrolment ‐ CR setting.
1.3
1.3. Analysis
Comparison 1 CR utilisation, Outcome 3 Enrolment ‐ intervention target.
1.4
1.4. Analysis
Comparison 1 CR utilisation, Outcome 4 Enrolment ‐ intervention contacts.
1.5
1.5. Analysis
Comparison 1 CR utilisation, Outcome 5 Enrolment ‐ deliverer.
1.6
1.6. Analysis
Comparison 1 CR utilisation, Outcome 6 Enrolment ‐ delivery format.
1.7
1.7. Analysis
Comparison 1 CR utilisation, Outcome 7 Enrolment ‐ theory‐based.
1.8
1.8. Analysis
Comparison 1 CR utilisation, Outcome 8 Enrolment ‐ outcome ascertainment.
1.9
1.9. Analysis
Comparison 1 CR utilisation, Outcome 9 Enrolment ‐ number of sites.
1.10
1.10. Analysis
Comparison 1 CR utilisation, Outcome 10 Enrolment ‐ cardiac indication.
1.11
1.11. Analysis
Comparison 1 CR utilisation, Outcome 11 Enrolment ‐ region.
1.12
1.12. Analysis
Comparison 1 CR utilisation, Outcome 12 Enrolment ‐ peer navigation.
1.13
1.13. Analysis
Comparison 1 CR utilisation, Outcome 13 Enrolment ‐ sensitivity analysis ‐ low risk of bias studies.
1.14
1.14. Analysis
Comparison 1 CR utilisation, Outcome 14 Enrolment ‐ sensitivity analysis ‐ without cluster RCT (Jolly).
1.15
1.15. Analysis
Comparison 1 CR utilisation, Outcome 15 Adherence.
1.16
1.16. Analysis
Comparison 1 CR utilisation, Outcome 16 Adherence ‐ deliverer.
1.17
1.17. Analysis
Comparison 1 CR utilisation, Outcome 17 Adherence ‐ delivery format.
1.18
1.18. Analysis
Comparison 1 CR utilisation, Outcome 18 Adherence ‐ number of sites.
1.19
1.19. Analysis
Comparison 1 CR utilisation, Outcome 19 Adherence ‐ cardiac indication.
1.20
1.20. Analysis
Comparison 1 CR utilisation, Outcome 20 Adherence ‐ CR setting.
1.21
1.21. Analysis
Comparison 1 CR utilisation, Outcome 21 Adherence ‐ region.
1.22
1.22. Analysis
Comparison 1 CR utilisation, Outcome 22 Adherence ‐ theory.
1.23
1.23. Analysis
Comparison 1 CR utilisation, Outcome 23 Adherence ‐ sensitivity analysis ‐ low risk of bias studies.
1.24
1.24. Analysis
Comparison 1 CR utilisation, Outcome 24 Completion.
1.25
1.25. Analysis
Comparison 1 CR utilisation, Outcome 25 Completion ‐ CR setting.
1.26
1.26. Analysis
Comparison 1 CR utilisation, Outcome 26 Completion ‐ delivery format.
1.27
1.27. Analysis
Comparison 1 CR utilisation, Outcome 27 Completion ‐ theory‐based.
1.28
1.28. Analysis
Comparison 1 CR utilisation, Outcome 28 Completion ‐ number of sites.
1.29
1.29. Analysis
Comparison 1 CR utilisation, Outcome 29 Completion ‐ cardiac indication.
1.30
1.30. Analysis
Comparison 1 CR utilisation, Outcome 30 Completion ‐ region.
1.31
1.31. Analysis
Comparison 1 CR utilisation, Outcome 31 Completion ‐ CR programme duration.
1.32
1.32. Analysis
Comparison 1 CR utilisation, Outcome 32 Completion ‐ sensitivity analysis ‐ low risk of bias studies.
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Update of

References

References to studies included in this review

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Kraal 2014 {published data only}
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Lynggaard 2017 {published data only}
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Mosleh 2014 {published data only}
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References to studies excluded from this review

Aamot 2014 {published data only}
    1. Aamot IL, Forbord SH, Gustad K, Lockra V, Stensen A, Berg AT, et al. Home‐based versus hospital‐based high‐intensity interval training in cardiac rehabilitation: a randomized study. European Journal of Preventive Cardiology 2014;21(9):1070‐8. [DOI: ] - PubMed
Antypas 2014 {published data only}
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Arietaleanizbeascoa 2015 {published data only}
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Arrigo 2008 {published data only}
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Barkley 2013 {published data only}
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Berg 2015 {published data only}
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Bikmoradi 2016 {published data only}
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Chokshi 2018 {published data only}
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Cooper 2016 {published data only}
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Daltroy 1985 {published data only}
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Dankner 2015 {published data only}
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Devi 2014 {published data only}
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Doletsky 2014 {published data only}
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Dougherty 2015 {published data only}
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Frederix 2013a {published data only}
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Frederix 2013b {published data only}
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Frederix 2014 {published data only}
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Frederix 2015 {published data only}
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Frederix 2016 {published data only}
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Fulton 2011 {published data only}
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Gaalema 2016 {published data only}
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Garcia 2013 {published data only}
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Hawkes 2013 {published data only}
    1. Hawkes AL, Patrao TA, Atherton J, Ware RS, Taylor CB, O'Neil A, et al. Effect of a telephone‐delivered coronary heart disease secondary prevention program (proactive heart) on quality of life and health behaviours: primary outcomes of a randomised controlled trial. International Journal of Behavioral Medicine 2013;20(3):413‐24. [DOI: ] - PubMed
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Irazusta‐Cordoba 2017 {published data only}
    1. Irazusta‐Cordoba FJ, Blazquez‐Bermejo Z, Castro‐Conde A, Dalmau‐Gonzalez‐Gallarza R, Velez‐Salas A, Hernandez‐Munoz D, et al. Impact of an intensive program on the outcomes of cardiac rehabilitation: MAS POR MENOS study. European Journal of Preventive Cardiology 2017;24(1):S36.
Izawa 2005 {published data only}
    1. Izawa K, Watanabe S, Omiya K, Hirano Y, Oka K, Osada N, et al. Effect of the self‐monitoring approach on exercise maintenance during cardiac rehabilitation: a randomized, controlled trial. American Journal of Physical Medicine and Rehabilitation 2005;84(5):313‐21. - PubMed
Kaminsky 2013 {published data only}
    1. Kaminsky L, Ozemek C, Riggin K, Byun W, Strath S. Pedometer feedback ‐ superior for increasing daily physical activity in cardiac rehabilitation patients. Circulation 2013;127(12):AP176.
Kidholm 2016 {published data only}
    1. Kidholm K, Rasmussen MK, Andreasen JJ, Hansen J, Nielsen G, Spindler H, et al. Cost‐utility analysis of a cardiac telerehabilitation program: the Teledialog Project. Telemedicine Journal and E‐health 2016;22(7):553‐63. - PMC - PubMed
Korzeniowska‐Kubacka 2014 {published data only}
    1. Korzeniowska‐Kubacka I, Bilinska M, Dobraszkiewicz‐Wasilewska B, Piotrowicz R. Comparison between hybrid and standard centre‐based cardiac rehabilitation in female patients after myocardial infarction: a pilot study. Kardiologia Polska 2014;72(3):269‐74. [DOI: ] - PubMed
Korzeniowska Kubacka 2015 {published data only}
    1. Korzeniowska‐Kubacka I, Bilinska M, Dobraszkiewicz‐Wasilewska B, Piotrowicz R. Hybrid model of cardiac rehabilitation in men and women after myocardial infarction. Cardiology Journal 2015;22(2):212‐8. [DOI: ] - PubMed
Lear 2014 {published data only}
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Lear 2015 {published data only}
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Lewinter 2014 {published data only}
    1. Lewinter C, Thygesen L, Doherty P, Kober L, Zwisler AD. Effectiveness of cardiac rehabilitation in HF patients: a long‐term follow‐up of the DANREHAB‐trial. European Journal of Heart Failure 2014;16:60. [DOI: 10.1002/ejhf.93_4] - DOI
Li 2015 {published data only}
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Mayer Berger 2016 {published data only}
    1. Mayer‐Berger WJ, Schroeer S, Pieper C. Positive effects of long‐term adherence to Viniyoga in high‐risk cardiac rehabilitation patients with systolic blood pressure between 140‐160 mmHg Refonet. European Journal of Preventive Cardiology 2016;23:S15. [DOI: 10.1177/2047487316668118] - DOI
Melin 2014 {published data only}
    1. Melin M, Hagglund E, Frie F, Lynga P, Ullman B, Persson H, et al. Patient‐centered home‐based management of heart failure, findings from a randomized clinical trial evaluating effects on knowledge, self‐care and quality of life. European Heart Journal 2014;35:838. [DOI: 10.1093/eurheartj/ehu324] - DOI - PubMed
Meng 2016 {published data only}
    1. Meng K, Musekamp G, Schuler M, Seekatz B, Glatz J, Karger G, et al. The impact of a self‐management patient education program for patients with chronic heart failure undergoing inpatient cardiac rehabilitation. Patient Education and Counseling 2016;99(7):1190‐7. [DOI: 10.1016/j.pec.2016.02.010] - DOI - PubMed
Mohammadi 2018 {published data only}
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Moholdt 2012 {published data only}
    1. Moholdt T, Bekken Vold M, Grimsmo J, Slordahl SA, Wisloff U. Home‐based aerobic interval training improves peak oxygen uptake equal to residential cardiac rehabilitation: a randomized, controlled trial. PLoS ONE 2012;7(7):e41199. [DOI: ] - PMC - PubMed
Moore 2006 {published data only}
    1. Moore SM, Charvat JM, Gordon NH, Pashkow F, RibislP, Roberts BL, et al. Effects of a CHANGE intervention to increase exercise maintenance following cardiac events. Annals of Behavioral Medicine 2006;31(1):53‐62. - PubMed
Murray 2014 {published data only}
    1. Murray KA, Murphy DJ, Clements SJ, Brown A, Connolly SB. Comparison of uptake and predictors of adherence in primary and secondary prevention of cardiovascular disease in a community‐based cardiovascular prevention programme (MyAction Westminster). Journal of Public Health 2014;36(4):644‐50. [DOI: ] - PubMed
O'Neil 2012 {published data only}
    1. O'Neil A, Hawkes A, Atherton J, Patrao T, Taylor C, Oldenburg B. Telephone‐delivered, health coaching improves psychological outcomes after myocardial infarction: the 'proactive heart' trial. Heart Lung and Circulation 2012;21:S315. [DOI: 10.1016/j.hlc.2012.05.779] - DOI - PubMed
Oerkild 2012 {published data only}
    1. Oerkild B, Frederiksen M, Hansen JF, Prescott E. Home‐based cardiac rehabilitation is an attractive alternative to no cardiac rehabilitation for elderly patients with coronary heart disease: results from a randomised clinical trial. BMJ Open 2012;2(6):e001820. [DOI: ] - PMC - PubMed
Pandey 2016 {published data only}
    1. Pandey AK, Patel T, Suskin N, Choudhry N. Education as a determinant of adherence to pharmacological and lifestyle interventions post‐myocardial infarction. Canadian Journal of Cardiology 2016;32:S158.
Pandey 2017 {published data only}
    1. Pandey A. Novel strategies to improve cardiometabolic status and adherence to exercise regimens in patients at high risk for cardiovascular disease (BURST). clinicaltrials.gov/ct2/show/nct03103854 (first received 6 April 2017).
Pattyn 2016 {published data only}
    1. Pattyn N, Vanhees L, Cornelissen VA, Coeckelberghs E, Maeyer C, Goetschalckx K, et al. The long‐term effects of a randomized trial comparing aerobic interval versus continuous training in coronary artery disease patients: 1‐year data from the SAINTEX‐CAD study. European Journal of Preventive Cardiology 2016;23(11):1154‐64. [DOI: 10.1177/2047487316631200] - DOI - PubMed
PeclatFlores 2015 {published data only}
    1. Peclat Flores PV, Arruda CS, Cavalcanti ACD, Pereira JMV, Scofano BS, Rocha BL, et al. Effect of a group orientation in self‐care and compliance of patients with heart failure. European Journal of Heart Failure 2015;17:165. [DOI: 10.1002/ejhf.277] - DOI
Peixoto 2015 {published data only}
    1. Peixoto TC, Begot I, Bolzan DW, Machado L, Reis MS, Papa V, et al. Early exercise‐based rehabilitation improves health‐related quality of life and functional capacity after acute myocardial infarction: a randomized controlled trial. Canadian Journal of Cardiology 2015;31(3):308‐13. [DOI: ] - PubMed
PfaeffliDale 2015a {published data only}
    1. PfaeffliDale L, Whittaker R, Dixon R, Stewart R, Jiang Y, Carter K, et al. Acceptability of a mobile health exercise‐based cardiac rehabilitation intervention: a randomized trial. Journal of Molecular Signal 2015;35(5):312‐9. [DOI: ] - PubMed
Piotrowicz 2012 {published data only}
    1. Piotrowicz E, Barbara DW, Grzebielichowski A, Jasionowska A, Maria BB, Gwilkowska J, et al. New model of home telemonitored cardiac rehabilitation based on nordic walking training in patients with heart failure: safety, effectiveness and compliance. Circulation 2012;125(19):e719. [DOI: 10.1161/CIR.0b013e31824fcd6b] - DOI
Piotrowicz 2015 {published data only}
    1. Piotrowicz E, Zielinski T, Bodalski R, Rywik T, Dobraszkiewicz‐Wasilewska B, Sobieszczanska‐Malek M, et al. Home‐based telemonitored Nordic walking training is well accepted, safe, effective and has high adherence among heart failure patients, including those with cardiovascular implantable electronic devices: a randomised controlled study. European Journal of Preventive Cardiology 2015;22(11):1368‐77. [DOI: ] - PubMed
Poortaghi 2013 {published data only}
    1. Poortaghi S, Baghernia A, Golzari SE, Safayian A, Atri SB. The effect of home‐based cardiac rehabilitation program on self efficacy of patients referred to cardiac rehabilitation center. BMC Research Notes 2013;6:287. [DOI: ] - PMC - PubMed
Reyes 2013 {published data only}
    1. Reyes JMA, Ruiz FM, Canete JA, Luque GN, Zafra RM, Gamez MG, et al. Secondary prevention of cardiovascular events: is an educational intervention helpful? A randomized clinical trial. European Journal of Cardiovascular Nursing 2013;12:S39. [DOI: 10.1177/1474515113477019] - DOI
Rodrigues 2013 {published data only}
    1. Rodrigues RC, Joao TM, Gallani MC, Cornelio ME, Alexandre NM. The "Moving Heart Program": an intervention to improve physical activity among patients with coronary heart disease. Revista Latino‐Americana de Enfermagem 2013;21 Spec No:180‐9. - PubMed
Ruivo 2017 {published data only}
    1. Ruivo JM, Karim K, OʼShea R, Oliveira RCS, Keary L, OʼBrien C, et al. In‐class active videogame supplementation and adherence to cardiac rehabilitation. Journal of Cardiopulmonary Rehabilitation and Prevention 2017;37(4):274‐8. [DOI: 10.1097/HCR.0000000000000224] - DOI - PubMed
Safiyari Hafizi 2016 {published data only}
    1. Safiyari‐Hafizi H, Taunton J, Ignaszewski A, Warburton DE. The health benefits of a 12‐week home‐based interval training cardiac rehabilitation program in patients with heart failure. Canandian Journal of Cardiology 2016;32(4):561‐7. [DOI: ] - PubMed
Sangster 2015 {published data only}
    1. Sangster J, Furber S, Allman‐Farinelli M, Phongsavan P, Redfern J, Haas M, et al. Effectiveness of a pedometer‐based telephone coaching program on weight and physical activity for people referred to a cardiac rehabilitation program: a randomized controlled trial. Journal of Molecular Signaling 2015;35(2):124‐9. [DOI: ] - PubMed
Sanjuan 2016 {published data only}
    1. Sanjuan P, Montalbetti T, Perez‐Garcia AM, Bermudez J, Arranz H, Castro A. A randomised trial of a positive Intervention to promote well‐being in cardiac patients. Applied Psychology Health Well Being 2016;8(1):64‐84. [DOI: ] - PubMed
Shahriari 2013 {published data only}
    1. Shahriari M, Ahmadi M, Babaee S, Mehrabi T, Sadeghi M. Effects of a family support program on self‐care behaviors in patients with congestive heart failure. Iranian Journal of Nursing Midwifery Research 2013;18(2):152‐7. - PMC - PubMed
Skobel 2017 {published data only}
    1. Skobel E, Knackstedt C, Martinez‐Romero A, Salvi D, Vera‐Munoz C, Napp A, et al. Internet‐based training of coronary artery patients: the Heart Cycle Trial. Heart and Vessels 2017;32(4):408‐18. [DOI: 10.1007/s00380-016-0897-8] - DOI - PubMed
Sniehotta 2006 {published data only}
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Takase 2015 {published data only}
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terHoeve 2018 {published data only}
    1. ter Hoeve N, Sunamura M, Stam HJ, Boersma E, Geleijnse ML, Domburg RT, et al. Effects of two behavioral cardiac rehabilitation interventions on physical activity: a randomized controlled trial. International Journal of Cardiology 2018;255:221‐8. - PubMed
Turkstra 2013 {published data only}
    1. Turkstra E, Hawkes AL, Oldenburg B, Scuffham PA. Cost‐effectiveness of a coronary heart disease secondary prevention program in patients with myocardial infarction: results from a randomised controlled trial (ProActive Heart). BMC Cardiovascular Disorders 2013;13:33. [DOI: ] - PMC - PubMed
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Vahedian Azimi 2016 {published data only}
    1. Vahedian‐Azimi A, Miller AC, Hajiesmaieli M, Kangasniemi M, Alhani F, Jelvehmoghaddam H, et al. Cardiac rehabilitation using the family‐centered empowerment model versus home‐based cardiac rehabilitation in patients with myocardial infarction: a randomised controlled trial. Open Heart 2016;3(1):e000349. [DOI: ] - PMC - PubMed
Vanhees 2014 {published data only}
    1. Vanhees L. Telerehabilitation in coronary heart disease (TRiCH). clinicaltrials.gov/ct2/show/nct02047942 (first received January 28 2014).
Widmer 2017 {published data only}
    1. Widmer RJ, Allison TG, Lennon R, Lopez‐Jimenez F, Lerman LO, Lerman A. Digital health intervention during cardiac rehabilitation: a randomized controlled trial. American Heart Journal 2017;188:65‐72. - PubMed
Wieczorrek 2016 {published data only}
    1. Wieczorrek G, Weber U, Wienke A, Egner E, Schroder J, Vogt A. Adherence to phase III cardiac rehabilitation programs: a prospective, randomized comparison between a conventionally conducted program and a Tai Chi‐based program [Adhärenz in Herzgruppen: Ein prospektiver, randomisierter Vergleich einer konventionell durchgefuhrten Herzgruppe zu einer Tai‐Chi‐Herzgruppe]. Sportverletzung Sportschaden 2016;30(2):95‐100. - PubMed
Wojcieszczyk 2012 {published data only}
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Wolszakiewicz 2015 {published data only}
    1. Wolszakiewicz J, Piotrowicz E, Foss‐Nieradko B, Dobraszkiewicz‐Wasilewska B, Piotrowicz R. A novel model of exercise walking training in patients after coronary artery bypass grafting. Kardiologia Polska 2015;73(2):118‐26. [DOI: ] - PubMed
Wood 2016 {published data only}
    1. Wood PW, Padwal RS. Feasibility and effectiveness of remote virtual reality‐based cardiac rehabilitation. clinicaltrials.gov/ct2/show/nct02711631 (first received 17 March 2016).
Young 2016 {published data only}
    1. Young L, Hertzog M, Barnason S. Effects of a home‐based activation intervention on self‐management adherence and readmission in rural heart failure patients: the PATCH randomized controlled trial. BMC Cardiovascular Disorders 2016;16(1):1. [DOI: 10.1186/s12872-016-0339-7] - DOI - PMC - PubMed

References to studies awaiting assessment

Ivers 2017 {published data only}
    1. Ivers N, Schwalm JD, Witteman HO, Presseau J, Taljaard M, McCready T, et al. Interventions supporting long‐term adherence and decreasing cardiovascular events (ISLAND): pragmatic randomized trial protocol. American Heart Journal 2017;190:64‐75. - PubMed
LaValley 2017 {published data only}
    1. Valley GA, Szalai H, Pack QR, Storer A. A telephone intervention to improve patient return rates in cardiac rehabilitation: a pilot study. AACVPR 32nd Annual Meeting Scientific Abstract Presentations. 2017; Vol. 37, issue 5:S209.
    1. Pack Q, Visintainer P, Farah M, LaValley G, Szalai H, Lindenauer PK. Risk stratification for non‐adherence in cardiac rehabilitation: a simple tool. AACVPR 33rd Annual Meeting Scientific Abstract Presentations. 2018; Vol. 38:S108.
Rouleau 2017 {published data only}
    1. Rouleau C, King‐Shier KM, Tomfohr‐Madsen LM, Bacon SL, Aggarwal S, Arena R, et al. The evaluation of a brief motivational intervention to promote intention to participate in cardiac rehabilitation: a randomized controlled trial. Patient Education and Counseling 2018;101:1914‐1923. - PubMed
Sunamura 2018 {published data only}
    1. Sunamura M, Ter Hoeve N, Berg‐Emons RJG, Geleijnse ML, Haverkamp M. Randomised controlled trial of two advanced and extended cardiac rehabilitation programmes. Heart 2018;104(5):430‐7. - PubMed
Suskin 2006 {published data only}
    1. Suskin N. Evaluation of an introductory videotape intervention to improve cardiac rehabilitation participation. clinicaltrials.gov/ct2/show/nct00372671 (first received 7 September 2006).
Taylor 2010a {published data only}
    1. Taylor GH. Improving cardiac rehabilitation session attendance: a randomised controlled trial. clinicaltrials.gov/ct2/show/results/NCT00956657 (first received 11 August 2010).

References to ongoing studies

Collela 2016 {published data only}
    1. Collela T. My Cardiac Recovery (MyCaRe): a pilot RCT. clinicaltrials.gov/ct2/show/NCT02778165 (first received 19 May 2016).
Gaalema 2014 {published data only}
    1. Gaalema D. Increasing cardiac rehabilitation participation among Medicaid enrollees. clinicaltrials.gov/ct2/show/NCT02172820 (first received 24 June 2014).
Suhar 2016 {published data only}
    1. Suhar C, Stuart E. Healing touch intervention in post‐cardiac event patients prior to starting a cardiac rehab program. clinicaltrials.gov/ct2/show/NCT02695134 (first received 1 March 2016).

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