Abstract 15107: Dramatic Impact of a Liaison-Mediated Referral Strategy on Cardiac Rehabilitation Participation After Percutaneous Coronary Intervention: Insights From the Blue Cross Blue Shield of Michigan Cardiovascular Consortium

Abstract

Background: While cardiac rehabilitation (CR) improves outcomes after percutaneous coronary intervention (PCI) it remains underutilized. A liaison-mediated referral, where a healthcare professional explains CR’s benefits and places a referral before discharge, may promote CR use. Hypothesis: We hypothesize a liaison-mediated CR referral is associated with greater CR participation after PCI. Methods: This was a retrospective cohort study of patients who underwent PCI across 48 hospitals in Michigan between January 2021 and April 2022 and were referred to CR before discharge. Clinical registry data was linked to Medicare and commercial claims to identify the primary outcome of CR participation, defined as attending ≥1 CR session within 90 days of discharge from the index PCI admission. Bayesian hierarchical logistic regression modeling was used to compare CR participation between patients with and without a liaison referral, adjusting for patient characteristics. Cox-proportional hazard modeling was used to compare days elapsed between discharge and first CR session between liaison cohorts. Results: Among 9,023 patients referred to CR after PCI, 4,323 (47.9%) underwent a liaison referral and 3,390 (37.6%) attended ≥1 CR session within 90 days of discharge. The liaison and non-liaison cohorts had a mean age of 69.3 vs 69.4 years, and 68.3% vs 68.4% were male, respectively. The liaison cohort had a higher unadjusted 90-day CR participation rate compared with the non-liaison cohort (Figure). After adjustment, the liaison cohort had a significantly higher odds of attending ≥1 CR session and a shorter delay in attending the first session compared with the non-liaison cohort (28 vs 33 days, p<0.001) (Figure). Conclusion: A liaison-mediated CR referral is associated with higher odds of post-PCI CR participation and may mitigate delays in CR enrollment. This may be an effective referral strategy to improve CR participation rates and patient outcomes after PCI.