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  • CDC: Rates of Cardiac Rehab Use Among Heart Attack Survivors 'Suboptimal'

    Despite the fact that cardiac rehabilitation (CR) significantly reduces the likelihood that a heart attack survivor will die of a later cardiac-related cause, only about 1 in 3 heart attack survivors in the US receive CR, according to a new analysis from the US Centers of Disease Control and Prevention (CDC). That's a "suboptimal" rate that represents "missed opportunities to access an evidence-based intervention that has been documented to improve patient survival, quality of life, functional status, and cardiovascular risk," the CDC writes in its report on the findings.

    Using results of the Behavioral Risk Surveillance System, a telephone survey conducted annually, the CDC analyzed rates of CR use for 20 states and the District of Columbia in 2013, and 4 states in 2015 (Georgia, Iowa, Maine, and Oregon—also in the 2013 group). Researchers found that not much changed over the 2-year span, with the average use of CR estimated at 33.7% in 2013 and 35.5% in 2015.

    The report also breaks down the use of CR by demographic and other variables. Among the findings:

    • Based on the 2013 data, men received CR more often than did women (36.4% compared with 28.8%), and whites more often than non-Hispanic blacks (35.4% compared with 25.3%).
    • An estimated 46.6% of college graduates received CR, 2 times the rate among individuals with less than a high school degree (23.3%) in 2013.
    • Individuals with some form of insurance in 2013 received CR at a rate of 34.4%, compared with 25.2% of individuals with no insurance.
    • Minnesota was the state with the highest percentage of CR use in 2013, at 58.6%; Hawaii was lowest, with a 20.7% rate.
    • In 2015, among the 4 states studied, Georgia had the lowest CR use rate, at 27.9%. Iowa had the highest rate, with 57.5% of heart attack survivors interviewed reporting that they had received CR.

    Authors of the analysis acknowledge several limitations to their study, including the potential unreliability of the self-reported survey responses, the lack of information on why patients didn't participate in CR, and no details on follow-through among the individuals who did report participating in CR. Still, they argue, those weaknesses don't overshadow the core conclusion: CR is being underused.

    "Health system interventions to promote [CR] referral and use, supported by access to affordable rehab programs within the community, should be prioritized to improve outcomes and prevent recurrent events," authors write. "Some strategies that might improve use of [CR] include higher payments for rehab by insurers, eliminating or reducing copays for patients, and extending [CR] clinical hours to improve access, as well as providing standardized referrals coupled with linkage to [CR] staff member liaisons at hospital discharge or by primary care providers and cardiologists."

    Research-related stories featured in PT in Motion News are intended to highlight a topic of interest only and do not constitute an endorsement by APTA. For synthesized research and evidence-based practice information, visit the association's PTNow website.

    Comments

    • Although the conclusion of Cardiac Rehab (CR) being underutilized is a sad & frustrating truth, my hope is that with continued education (especially in areas of disparity), improved accessibility, decreased cost to patients in need (i.e. co-pays), and real-life stories shared CR will become more the norm & attached to the majority of (appropriate) cardiovascular events for both quality of life & decreasing future long-term health care costs. Not sure when we will adapt proactive healthcare over the current reactive system that is currently embraced or in my opinion forced on us.

      Posted by A. Davis on 8/31/2017 11:20 AM

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