Factors Contributing to Cardiac Rehabilitation Uptake Among Patients with Coronary Artery Disease in Thailand: A Nationwide Cross-Sectional Study
Keywords:
rehabilitation, cardiac rehabilitation, secondary prevention, cardiovascular diseases, barrier, attendanceAbstract
Objectives: This study aimed to identify factors contributing to cardiac rehabilitation (CR) uptake among patients with coronary artery disease (CAD) in Thailand.
Study design: A descriptive survey study
Setting: Data collection took place at an urban and a rural hospital.
Subjects: Patients were eligible for the study if they had been referred for CR by the medical staff during their in-patient stay.
Methods: Data were collected from June 2018 to July 2019. Patients with CAD attending either the urban or the rural hospital completed the Cardiac Rehabilitation Barriers Scale (CRBS) questionnaire which surveyed barriers to CR uptake.
Results: The mean age of the 138 respondents was 64 years with 68.8% aged 60 or older; 70% were male, and 67.4% were CR attendees. Patients aged 60-69 were found to have the highest uptake of CR. Rural patients with CAD differed from those from urban areas in having a lower level of education (X2 (2, n = 67) = 14.58, p = 0.001, phi= 0.466) and lower family income (X2 (2, n = 67) = 9.60, p = 0.008, phi = 0.379). Rural patients with fewer years of formal education and those who were farmers were less likely to attend CR. Rural patients reported more barriers to CR than did urban participants. The main barriers to CR uptake for rural patients were distance from and transportation to the clinic.
Conclusions: While the existing CR hospital-based programs in Thailand may be appropriate for urban patients with CAD, they are less useful for patients living in rural areas. Existing CR programs should be modified to include more nuanced approaches to CR suitable for rural patients.
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