Abstract
BackgroundThe presence of mental health conditions in cardiac rehabilitation (CR) patients such as anxiety and depression can lead to reduced programme adherence, increased mortality and increased re-occurrence of cardiovascular events undermining the aims and benefit of CR. Earlier research has identified a relationship between delayed commencement of CR and poorer physical activity outcomes. This study wished to explore whether a similar relationship between CR wait time and mental health outcomes can be found and to what degree participation in CR varies by mental health status.MethodsData from the UK National Audit of Cardiac Rehabilitation, a dataset that captures information on routine CR practice and patient outcomes, was extracted between 2012 and 2016. Logistic and multinomial regression models were used to explore the relationship between timing of CR and mental health outcomes measured on the hospital anxiety and depression scale.ResultsThe results of this study showed participation in CR varied by mental health status, particularly in relation to completion of CR, with a higher proportion of non-completers with symptoms of anxiety (5% higher) and symptoms of depression (8% higher). Regression analyses also revealed that delays to CR commencement significantly impact mental health outcomes post-CR.ConclusionIn these analyses CR wait time has been shown to predict the outcome of anxiety and depression status to the extent that delays in starting CR are detrimental. Programmes falling outside the 4-week window for commencement of CR following referral must strive to reduce wait times to avoid negative impacts to patient outcome.
Highlights
An estimated 85 million people in Europe live with cardiovascular disease.[1]
A systematic review of depression prevalence in acute myocardial infarction survivors reported major depression was present in 19.8% of the population and the proportion with significant symptoms varied between 15% and 31% depending on the type of screening instrument used.[5]
Utilisation, patient characteristics and their respective outcomes are entered onto the National Audit of Cardiac Rehabilitation (NACR) by practitioners involved in cardiac rehabilitation (CR) delivery, according to a data dictionary
Summary
An estimated 85 million people in Europe live with cardiovascular disease.[1]. As survival rates improve, following acute cardiac events, this number is only set to rise.[2]. The presence of mental health conditions in cardiac rehabilitation (CR) patients such as anxiety and depression can lead to reduced programme adherence, increased mortality and increased re-occurrence of cardiovascular events undermining the aims and benefit of CR. This study wished to explore whether a similar relationship between CR wait time and mental health outcomes can be found and to what degree participation in CR varies by mental health status. Regression analyses revealed that delays to CR commencement significantly impact mental health outcomes post-CR. Conclusion: In these analyses CR wait time has been shown to predict the outcome of anxiety and depression status to the extent that delays in starting CR are detrimental. Programmes falling outside the 4-week window for commencement of CR following referral must strive to reduce wait times to avoid negative impacts to patient outcome
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