Murray Kathryn A, Murphy David J, Clements Sarah-Jane, Brown Adrian, Connolly Susan B
MyAction Westminster, Imperial College Healthcare NHS Trust, 5th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK Department of Neuropsychology and Clinical Health Psychology, 10th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
Department of Neuropsychology and Clinical Health Psychology, 10th Floor, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK.
J Public Health (Oxf). 2014 Dec;36(4):644-50. doi: 10.1093/pubmed/fdt118. Epub 2013 Dec 13.
Despite the benefits of cardiac rehabilitation, uptake and adherence remain suboptimal. With the advent of NHS Health Checks, primary prevention programmes have also been advocated, but little is known about uptake and adherence rates. This study examined rates and predictors of adherence amongst patients with cardiovascular disease (CVD) and those at high multifactorial risk (HRI) attending an innovative programme integrating primary and secondary prevention.
Comparison of rates of uptake and adherence and also predictors of adherence between 401 CVD patients and 483 HRI. The outcome was the number of sessions attended and predictor variables included clinical and psychosocial variables. Differences between groups were examined using t-tests and non-parametric tests. Multivariable regression analyses examined predictors of adherence.
Uptake to the assessment (CVD: 97%, HRI: 88%) and the programme (CVD: 78%, HRI: 74%) were high for both groups. An average of 8/12 was attended in both groups. Beliefs about treatment predicted adherence for both groups (P < 0.01). The alcohol causal belief also predicted poorer adherence amongst CVD patients (P < 0.02). Older age also predicted better adherence amongst HRI (P < 0.001).
Rates of uptake and adherence were high for both HRI and CVD patients. Further research is needed to examine whether interventions targeting predictor variables further improve adherence.
尽管心脏康复有益，但参与率和依从性仍不尽人意。随着英国国家医疗服务体系健康检查的出现，一级预防项目也得到了倡导，但对于其参与率和依从率却知之甚少。本研究调查了参加一项整合了一级和二级预防的创新项目的心血管疾病（CVD）患者和多因素高风险（HRI）患者的依从率及预测因素。
比较401名CVD患者和483名HRI患者的参与率和依从率以及依从性的预测因素。结果是参加的课程数量，预测变量包括临床和心理社会变量。使用t检验和非参数检验检查组间差异。多变量回归分析检查依从性的预测因素。
两组对评估的参与率（CVD：97%，HRI：88%）和对项目的参与率（CVD：78%，HRI：74%）都很高。两组平均参加了8/12的课程。对治疗的信念预测了两组的依从性（P < 0.01）。酒精因果信念也预测了CVD患者中较差的依从性（P < 0.02）。年龄较大也预测了HRI中较好的依从性（P < 0.001）。
HRI和CVD患者的参与率和依从率都很高。需要进一步研究以检查针对预测变量的干预措施是否能进一步提高依从性。
