Analysis of medium-term adherence after the implementation of a cardiac rehabilitation program

Alejandra Ruiz-Aranjuelo, Unidad de Rehabilitación Cardiaca, Hospital Nuestra Señora de Gracia; Servicio de Cardiología, Hospital Universitario Miguel Servet; Zaragoza, España
Maruan C. Chabbar-Boudet, Unidad de Rehabilitación Cardiaca, Hospital Nuestra Señora de Gracia; Servicio de Cardiología, Hospital Universitario Miguel Servet; Zaragoza, España
Elena P. Gambó-Ruberte, Unidad de Rehabilitación Cardiaca, Hospital Nuestra Señora de Gracia; Servicio de Cardiología, Hospital Universitario Miguel Servet; Zaragoza, España
Carmen Albarrán-Martín, Unidad de Rehabilitación Cardiaca, Hospital Nuestra Señora de Gracia; Servicio de Cardiología, Hospital Clínico Universitario Lozano Blesa; Zaragoza, España
Carmen Untoria-Agustín, Unidad de Rehabilitación Cardiaca, Hospital Nuestra Señora de Gracia; Servicio de Rehabilitación y Medicina Física, Hospital Royo Villanova; Zaragoza, España
Fernando Garza-Benito, Unidad de Rehabilitación Cardiaca, Hospital Nuestra Señora de Gracia; Servicio de Cardiología, Hospital Royo Villanova. Zaragoza, España

Objectives: Cardiac Rehabilitation Programs (CRP) are an excellent tool to achieve adherence to therapeutic. The aim of our study was analyzing at the medium-term adherence, as well as identifying low adherence predictors to pharmacological therapeutic compliance and changes in lifestyle. Methods: Retrospective study of 100 patients referred to a CRP in 2018 after presenting ACS. At the one-year review adherence to diet, physical exercise, and smoking cessation were analyzed. Optimal adherence was considered if all three items were met. Compliance with taking medication was also studied using the Morisky-Green test. Finally, low adherence predictors were analyzed by lineal/logistic regression analysis. Results: 98% of the patients presented acceptable adherence to the Mediterranean diet, 83% good adherence to physical exercise, and 79% of the smokers achieved the cessation of smoking. Regarding drug adherence, 97% of the patients complied correctly. 68% of the patients achieved good overall adherence. Eastern European nationality, sedentary lifestyle, and home-based CRP were predictors of low adherence. The youngest patients and the “blue collar” occupation showed a tendency to poor adherence, although not significantly. Conclusions: In our environment there is good medium-term adherence to lifestyle changes and pharmacological compliance in patients who complete CRP after ACS. Eastern European nationality, sedentary lifestyle, and home-based programs were associated with poor adherence.

Keywords: Adherence. Cardiac rehabilitation. Acute coronary syndrome.