Abstract 250: Psychosocial Assessment And Services Provided By Licensed Cardiac Rehabilitation Programs

Abstract

Background: Professional health organizations recommend that outpatient cardiac rehabilitation (CR) programs include activities to optimize the physical, mental, and social well-being of patients. How these guidelines are being put into practice is not well known so there is a critical need to describe the real-world implementation of psychosocial guidelines in CR programs. To meet this need, the study objectives were to describe 1) mental health assessments performed and 2) psychosocial services offered among CR programs. Methods: A cross-sectional survey of North Carolina licensed outpatient CR programs was conducted. The online survey was designed to obtain descriptive information on CR personnel, assessments completed, services offered, and the patient population that is served by each program in 2018. Descriptive statistics were used to summarize mental health assessments and other closed-question responses. Standardized differences were computed to detect an imbalance in characteristics between CR programs that did and did not provide psychosocial services. Thematic analysis of free text responses to psychosocial services offered was performed by 2 team members until consensus was reached. Results: Sixty-eight programs (89%) responded to the survey. Forty-eight programs (70%) indicated offering psychosocial services. At program enrollment, mental health was assessed in 94% of programs of which 92% repeated the assessment at discharge. Depression was assessed with the 9-item Patient Health Questionnaire by a majority (75%) of programs. Health-related quality of life (QoL) instruments were used by 60 (88%) programs. Health-related QoL was assessed at program enrollment and conclusion by 95% of programs that completed this type of assessment. Psychosocial services included individual counseling (59%), counseling referrals (49%), and educational classes (29%). Conclusions: Cardiac rehabilitation programs routinely screen for psychosocial distress, a known risk factor for heart disease. CR programs can identify patients at risk for mental health problems following an MI and be a resource for connection to appropriate services.