Multivariate models for compliance with phase 3 cardiac rehabilitation services in Johannesburg.

The efficacy of an exercise cardiac rehabilitation programme depends on an adequate compliance of its participants. A 50% dropout rate after 12 months has been reported by most rehabilitation programmes. Compliance with attendance and the exercise prescription are monitored daily at the Johannesburg Cardiac Rehabilitation Centre. This study evaluated the attendance of 711 patients admitted to the programme between June 1986 and March 1990 and looked at possible differences in attendance and intensity rates of compliers and dropouts prior to dropout. Multiple regression analyses were performed on all patients using different measures of exercise compliance as dependent variables and patient characteristics on admission as explanatory variables in order to establish possible associations which could identify potential dropouts at an early stage. We found that 36% of patients dropped out by 12 months and that 50% managed to complete our 18 month programme. Dropouts complied less than compliers in terms of attendance and intensity before dropping out. Significant associations were found between the measures of compliance and patient characteristics. Age, smoking, peak oxygen uptake and a measure of hostility were identified as predictive factors. With the exception of the energy expended per session the variation in the other measures of compliance was poorly explained by the explanatory variables suggesting that other factors could be related to compliance at the Johannesburg Cardiac Rehabilitation Centre and need to be further evaluated.