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Clinical Trial
. 2024 Dec 18;24(1):1579.
doi: 10.1186/s12913-024-12073-x.

Reducing dropout rates in cardiac rehabilitation among cardiac patients in a vulnerable situation: systematic development and feasibility testing of the Heart Priority Programme

Charlotte Ibsen  1 , Kirstine Kold Katholm  2   3 , Anja Jakobsen  3 , Gitte Bastrup Eriksen  4 , Lene Lysdal  5 , Ulla Kirkegård Nielsen  5 , Maiken Bay Ravn  6 , Thomas Maribo  6   2
Affiliations
Clinical Trial

Reducing dropout rates in cardiac rehabilitation among cardiac patients in a vulnerable situation: systematic development and feasibility testing of the Heart Priority Programme

Charlotte Ibsen et al. BMC Health Serv Res. .

Abstract

Background: Despite advancements in reducing cardiovascular disease, it remains a major health concern. Cardiac rehabilitation (CR) has a positive impact on morbidity, mortality, and functioning, but faces high dropout rates especially among vulnerable patients, due to social inequalities and insufficiently tailored interventions. To address this, we developed the Heart Priority Programme targeting and supporting cardiac patients at risk of dropout. This study outlines the development of the Heart Priority Programme and share findings from a feasibility test.

Methods: An iterative three-stage process involving cardiac patients and healthcare professionals from three community healthcare services, guided the development of the programme. Stage 1 included reviewing evidence, consulting stakeholders, and observing practice. In stage 2, a project-group of researchers and healthcare professionals was established to co-produce the programme. Stage 3 included field-testing and local adaptions. Subsequently, the programme was feasibility tested in a single-arm follow-up study across two community healthcare services. Over six months, process data on implementation, acceptability, and mechanism of impact were gathered.

Results: The Heart Priority Programme was development from January 2023 to June 2023, comprising two main parts: 1) an evidence-based identification form with 13 risk factors to identify patients at risk of dropout (referred to as priority patients), and 2) an add-on intervention targeted these patients with three core elements-assigning a contact person, systematic communication, and follow-up. During a six-month feasibility phase, 260 patients were included. Of these, 91 (35%) were identified as priority patients. CR teams found that the programme was relevant, easy to integrate into daily workflow, and applicable in practice. Patient consultations yielded positive feedback on the three core elements of the add-on intervention.

Conclusions: This paper outlines the development and feasibility test of the Heart Priority Programme, co-produced to identify, and support priority patients. The programme, developed through a three-stage iterative co-production process, was found relevant and easy to implement in community healthcare services. CR teams valued its structured approach to supporting priority patients, and patients found it aligned with their needs. Although initial results are promising, further research is needed to evaluate the programme's effectiveness and suitability for widespread implementation.

Trial registration: ClinicalTrials.gov NCT06575764, registered retrospectively on 28 August 2024.

Keywords: Cardiac rehabilitation; Co-production; Dropout; Feasibility; Healthcare access; Vulnerable populations.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was registered and approved by the Data Protection Agency of Central Denmark Region (1–16-02–121-24). According to Danish legislation and the Act on Biomedical Research Ethics Committee System in Denmark, research without human biological material does not require approval from an ethics committee (§14 Sect. 2). All participants received oral and written information regarding the study and provided written informed consent to participate in this study. Anonymity was ensured for all participants during the analysis and in the presentation of the findings. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Three-stage development process of the Heart Priority Programme
See this image and copyright information in PMC

References

    1. Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Back M, et al. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol. 2021;29(1):5–115. - PubMed
    1. Cowie A, Buckley J, Doherty P, Furze G, Hayward J, Hinton S, et al. Standards and core components for cardiovascular disease prevention and rehabilitation. Heart (British Cardiac Society). 2019;105(7):510–5. - PMC - PubMed
    1. Dibben GO, Faulkner J, Oldridge N, Rees K, Thompson DR, Zwisler AD, et al. Exercise-based cardiac rehabilitation for coronary heart disease: a meta-analysis. Eur Heart J. 2023;44(6):452–69. - PMC - PubMed
    1. de Araújo Santiago C, Chaves GS, Davies P, Taylor RS, Grace SL. Interventions to promote patient utilisation of cardiac rehabilitation. Cochrane Database Syst Rev. 2019;2(2):Cd0071317131. - PMC - PubMed
    1. Turk-Adawi KI, Grace SL. Narrative review comparing the benefits of and participation in cardiac rehabilitation in high-, middle- and low-income countries. Heart Lung Circ. 2015;24(5):510–20. - PMC - PubMed

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