Outpatient Cardiac Rehabilitation Services, Participants and Workforce in North Carolina: Results of a 2019 Survey of Cardiac Rehabilitation Program Directors.

Abstract

BACKGROUND Cardiac rehabilitation (CR) can improve quality of life and reduce subsequent hospitalizations for individuals with cardiovascular disease. Nevertheless, CR is underutilized, and less is known about the current content, patient population, and workforce of CR programs in North Carolina.OBJECTIVE To describe CR services, patient participation, and workforce in North Carolina in order to characterize CR infrastructure and identify opportunities to improve CR use.METHODS We distributed an electronic survey to all certified outpatient CR programs in North Carolina in spring 2019. Descriptive statistics were used to summarize program characteristics, participant characteristics, and current workforce. Data were analyzed overall and by region.RESULTS Responding programs (89.5% response rate, n=68) had been in operation for a mean of 24 (SD: 10.4) years. Programs have similar availability across the state, operating 4 days a week with 5 sessions per day. A majority of programs offered nutrition counseling (98.5%), stress management (94.1%), aerobic exercise (86.8%), and weight training (86.8%). Patients were majority male (65%), aged 65 or older (75%), and White (75%). Nearly half of patients referred to CR attended at least 1 session, though 25% discontinued early. Most programs were staffed by a median of 2 full-time nurses (97%) and by a median of 1.5 full-time exercise physiologists (96%). Mental health and administrative professionals were less frequent in CR settings.LIMITATIONS Since this survey was primarily completed by program directors, further research is needed to understand the challenges, experiences, and needs of the frontline CR workforce, as well as the direct experiences of patients who participate in CR.CONCLUSIONS CR programs in North Carolina offer a range of services. While half of patients referred to CR initiate services, interventions are needed to improve initiation and adherence to CR.