Factors Related to Participation in Cardiac Rehabilitation in Patients With Acute Coronary Syndrome
Condition: Acute Coronary Syndrome; Cardiovascular Diseases; Cardiac Rehabilitation
MeSH terms: Cardiovascular Diseases; Acute Coronary Syndrome; Syndrome
Study type: Observational

Summary: 
      Acute coronary syndrome (ACS) is one of the most important causes of mortality and morbidity
      all over the world. Cardiac rehabilitation (CR) is a crucial part of secondary prevention and
      optimal care of patients with ACS. However, the participation rate in CR after ACS is far
      from expected. In our study, we will aim to examine the rate of participation in cardiac
      rehabilitation and the factors affecting it in patients followed up for acute coronary
      syndrome in the coronary intensive care unit of our hospital. Our main hypothesis is that the
      lower rate of participation in cardiac rehabilitation in patients with acute coronary
      syndrome is associated with one or more of that older age, female gender, multimorbidity,
      poor functional capacity, lower health literacy level or quality of life levels.
    

Detailed description: 
      Acute coronary syndrome (ACS) is an umbrella term comprising unstable angina, myocardial
      infarction (MI) with or without ST-segment elevation, and sudden cardiac death because of
      acute myocardial ischemia. ACS is one of the most important causes of mortality and morbidity
      all over the world. Today, cardiac rehabilitation has become an integral part of the medical
      care and secondary prevention programs of cardiovascular diseases including ACS. Cardiac
      rehabilitation (CR) is a long-term comprehensive rehabilitation program that includes but not
      limited to patient evaluation, determination of risk profile, patient-tailored exercise
      training, and behavioural and lifestyle changes aiming at risk reduction in cooperation with
      many disciplines. It consists of comprehensive interventions. Despite its known benefits and
      recommended in national and international guidelines, the participation rate in cardiac
      rehabilitation is lower than expected. Studies involving different countries and societies
      showed that lower participation was associated with inadequate referral, female gender, poor
      motivation, older age, comorbidities, difficulty in transportation, and poor socioeconomic
      status. It has been suggested that setting up a CR appointment before discharge via clinical
      visits by the CR team or automatic referral systems, increasing patient interest and
      knowledge through written invitations and brochures, and providing support for transportation
      may increase participation in CR.

      In our country, there are not enough studies addressing the success of participation and
      compliance in cardiac rehabilitation. In this study, we aim to determine patient related
      factors associated with low participation in CR in patients admitted to our coronary
      intensive care unit (ICU) with ACS diagnosis. All patients included in this study will be
      comprehensively informed about CR and the initial CR session will be scheduled to minimize
      effect of inadequate referral.
    

Intervention name(s): Invitation to the CR
Intervention type(s): Behavioral
Intervention description(s): Oral and written information emphasise the benefits of cardiac rehabilitation in terms of treatment of heart diseases, increasing functional capacity, reducing morbidity and mortality, and enhancing secondary prevention.
Introducing the scope and method of administration of CR to patients.
Setting up the appointment for the initial CR session four weeks later.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients aged 18-75 years admitted to the coronary intensive care unit with the diagnosis
        of acute coronary syndrome
      
Keywords: Acute Coronary Syndrome; Cardiac Rehabilitation; Myocardial Infarction; Participation; Health Literacy; Rehabilitation Barriers