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Heart Asia. 2018 Jan 26;10(1):e010976. doi: 10.1136/heartasia-2017-010976. eCollection 2018.

Patient preferences for types of community-based cardiac rehabilitation programme.

Author information

1
Duke-NUS Medical School, Singapore.
2
Department of Pharmacy, National University of Singapore, Singapore.
3
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
4
Faculty of Dentistry, National University of Singapore, Singapore.
5
Heart Wellness Centre, Singapore Heart Foundation, Singapore.
6
Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.
7
Department of Family Medicine and Continuing Care, Singapore General Hospital, Singapore.
8
Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore.

Abstract

Introduction:

Cardiac rehabilitation (CR) improves mortality, morbidity and quality of life of cardiovascular patients. However, its uptake is poor especially in the hospitals due to long travel distances and office hours constraints. Community-based CR is a possible solution.

Objectives:

To understand the type of community-based CR preferred and identify patient characteristics associated with certain programme combinations.

Methods:

A cross-sectional survey was administered to a randomised list of patients at risk for or with cardiovascular diseases at two community-based CR centres. Participants were presented with nine hypothetical choice sets and asked to choose only one of the two alternative programme combinations in each choice set. Attributes include support group presence, cash incentives, upfront deposit and out-of-pocket cost. The counts for each combination were tallied and corrected for repeats. Chi-square test and logistic regression were performed to understand the characteristics associated with the preferred CR combination.

Results:

After correcting for repeats, patients most (85.2%) prefer CR programmes with new group activities, support group, cash rewards, deposit and out-of-pocket cost, and few exercise equipment with physiotherapist presence without the need for monitoring equipment. Patients with more than three bedrooms in their house are less likely (OR 0.367; CI 0.17 to 0.80; P=0.011) to choose the choice with no physiotherapist and few equipment available.

Conclusion:

This is the first study to explore patients' preferences for different types of community CR. Higher income patients prefer physiotherapist presence and are willing to settle for less equipment. Our study serves as a guide for designing future community-based CR programmes.

KEYWORDS:

cardiac rehabilitation; community cardiology; delivery of care

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