Ruano-Ravina Alberto, Pena-Gil Carlos, Abu-Assi Emad, Raposeiras Sergio, van 't Hof Arnoud, Meindersma Esther, Bossano Prescott Eva Irene, González-Juanatey Jose Ramón
Department of Preventive Medicine & Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Spain.
Service of Cardiology, Clinical University Hospital of Santiago de Compostela, Santiago de Compostela, Spain.
Int J Cardiol. 2016 Nov 15;223:436-443. doi: 10.1016/j.ijcard.2016.08.120. Epub 2016 Aug 13.
Acute myocardial infarction (AMI) is an important health problem. Cardiac rehabilitation (CR) programs following AMI have shown to be effective in reducing mortality. We aim to systematically review the existing literature that analyzes the factors that affect participation and adherence to cardiac rehabilitation programs. We reviewed Medline, EMBASE and Cochrane databases from 01/01/2004 to June 2016 using predefined inclusion and exclusion criteria. We classified the results into factors affecting participation and factors influencing adherence to CR programs. We included 29 studies, and there was a general agreement in those factors predicting participation and adherence to CR programs. These factors can be classified into person-related factors and aspects related to CR programs. Older participants, women, patients with comorbidities, unemployed and uncoupled persons, less educated people and those with lower income had a lower participation. A similar pattern was observed for CR adherence. Also, those potential participants who live farther from CR facilities, do not have transportation, or do not drive, attended less to CR programs. These factors were very similar when analyzing adherence to CR programs. These aspects were similar in Europe and the USA. These results clearly show that participation in CR programs follows a determined pattern that is very homogeneous in different settings. Health professionals should also be aware of patients reluctant to participate in CR programs and adapt their messages and redesign CR programs, to promote participation and adherence.
急性心肌梗死（AMI）是一个重要的健康问题。急性心肌梗死后的心脏康复（CR）项目已被证明在降低死亡率方面有效。我们旨在系统回顾现有文献，分析影响参与心脏康复项目及坚持康复治疗的因素。我们使用预先设定的纳入和排除标准，检索了2004年1月1日至2016年6月期间的Medline、EMBASE和Cochrane数据库。我们将结果分为影响参与的因素和影响坚持心脏康复项目的因素。我们纳入了29项研究，对于预测参与和坚持心脏康复项目的因素存在普遍共识。这些因素可分为与个人相关的因素和与心脏康复项目相关的方面。年龄较大的参与者、女性、患有合并症的患者、失业及单身人士、受教育程度较低者以及收入较低者参与度较低。在心脏康复的坚持方面也观察到类似模式。此外，那些居住距离心脏康复机构较远、没有交通工具或不会开车的潜在参与者参加心脏康复项目的次数较少。在分析心脏康复项目的坚持情况时，这些因素非常相似。在欧洲和美国，这些方面也相似。这些结果清楚地表明，参与心脏康复项目遵循一种确定的模式，在不同环境中非常一致。卫生专业人员也应意识到那些不愿参与心脏康复项目的患者，并调整他们的宣传内容，重新设计心脏康复项目，以促进参与和坚持。
