Cardiac rehab referrals up, but not enrollment

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Enrollment is particularly low among Hispanic and black patients, researchers report in the American Journal of Cardiology.

NEW YORK (Reuters Health) - Although the American Heart Association's "Get With The Guidelines" program has led to more patients being referred for cardiac rehabilitation by their physicians, most patients who are referred don't actually enroll.

Enrollment is particularly low among Hispanic and black patients, researchers report in the American Journal of Cardiology.

To further investigate this issue, Dr. Gary J. Balady of Boston University School of Medicine and colleagues reviewed the records of 780 patients who were discharged after being hospitalized for a heart attack. The researchers found that 714 patients (92 percent) were treated accorded to the AMA guidelines. Of these patients, 392 (55 percent) were referred for rehab, but only 135 (19 percent) eventually enrolled.

Although ethnicity or race did not affect the referral rates, it was the only factor related to lower enrollment. Hispanic patients were 92 percent less likely than whites to enroll, and blacks were 57 percent less likely to enroll.

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Among the factors associated with higher referral rates were inpatient physical therapy consultation and percutaneous coronary intervention, also referred to as angioplasty, which involves insertion of a catheter into the coronary artery to remove the blockage that caused the heart attack.

The researchers point out that referral rates were higher than the 10 to 15 percent reported in other studies. Even so, they caution: "Strategies to bridge the gap between referral and enrollment in cardiac rehabilitation" are necessary, "with special emphasis on increasing enrollment in ethnic minorities."

SOURCE: American Journal of Cardiology, May 2008.