Cardiac Rehabilitation
Conditions
Keywords
Randomised Controlled Trial, Adherence, Patient Participation
Brief summary
Cardiac rehabilitation (CR) programmes typically offer patients with heart disease a long-term programme of medical evaluation, exercise, education and counseling. National guidelines have recognized the positive impact that attendance at CR can have following heart attacks, angina and other heart problems. Patients who attend such a programme have been shown to have reduced health problems. Despite this, research suggests that the use of these services is poor and that the majority of patients eligible for these programmes do not continue to attend after their first class. A range of factors have been associated with non-adherence to CR, including psychological factors such as people's beliefs about their illness. For example, patients with high levels of perceived control over their illness after a heart attack appear to be more likely to attend CR classes than those with low levels of perceived control. Such findings suggest that changing patients' illness beliefs, specifically those associated with illness control and illness consequences, could help to increase adherence to CR programmes. Increased adherence to CR could improve health outcomes for patients with cardiac illnesses. The present study is therefore investigating the effectiveness of a one-session psychological intervention, based on a theory called the Self-Regulatory Model, in altering beliefs about illness among patients starting cardiac rehabilitation. Participants will be randomly assigned to a treatment or a non-treatment group. It is hoped that those who receive the treatment session will attend more CR classes.
Interventions
BEHAVIORALPsychological Intervention Session
One-off session aimed at changing participants beliefs around illness control and consequences, applied using a motivational interviewing style.
Sponsors
NHS Greater Glasgow and Clyde
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Attending first cardiac rehabilitation class at one of three hospital sites * Participants had to be over 18
Exclusion criteria
* Unable to read and understand English information sheet and consent form
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CR Adherence | Approximately 3-months after recruitment | Number of cardiac rehabilitation classes attended in total. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Illness Perceptions Questionnaire-Revised Scores | 3-months after consent | Eight sub-scale scores obtained. Sub-scales include; Illness consequences, Illness Control, Treatment Control, Illness Identity, Emotional Representation, Illness Cause, Illness Coherence, Timeline Cyclical. Minimum and Maximum scores vary for each sub-scale. |
Countries
United Kingdom
Participant flow
Recruitment details
Recruitment began in November 2008 and was completed in May 2009. All recruitment took place in out-patient cardiac rehabilitation departments within hospital buildings.
Participants by arm
| Arm | Count |
|---|---|
| Treatment Group Single treatment session provided by study PI. Session aimed to change participant illness beliefs using motivational interviewing techniques in order to improve adherence to cardiac rehabilitation classes. | 18 |
| Treatment As Usual Control group. Treatment received as usual. | 13 |
| Total | 31 |
Baseline characteristics
| Characteristic | Treatment As Usual | Treatment Group | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 4 Participants | 6 Participants | 10 Participants |
| Age, Categorical Between 18 and 65 years | 9 Participants | 12 Participants | 21 Participants |
| Age Continuous | 61 years STANDARD_DEVIATION 10.6 | 63 years STANDARD_DEVIATION 9.6 | 62 years STANDARD_DEVIATION 9.9 |
| Region of Enrollment United Kingdom | 13 participants | 18 participants | 31 participants |
| Sex: Female, Male Female | 2 Participants | 4 Participants | 6 Participants |
| Sex: Female, Male Male | 11 Participants | 14 Participants | 25 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 18 | 0 / 13 |
| serious Total, serious adverse events | 0 / 18 | 0 / 13 |
Outcome results
Primary
CR Adherence
Number of cardiac rehabilitation classes attended in total.
Time frame: Approximately 3-months after recruitment
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Treatment Group | CR Adherence | 16.0 Classes Attended | Standard Deviation 5.2 |
| Treatment As Usual | CR Adherence | 14.4 Classes Attended | Standard Deviation 6.2 |
Secondary
Illness Perceptions Questionnaire-Revised Scores
Eight sub-scale scores obtained. Sub-scales include; Illness consequences, Illness Control, Treatment Control, Illness Identity, Emotional Representation, Illness Cause, Illness Coherence, Timeline Cyclical. Minimum and Maximum scores vary for each sub-scale.
Time frame: 3-months after consent