Article

Secondary prevention programs such as cardiovascular rehabilitation
significantly decrease the burden of cardiovascular disease, yet are under-used.
The most successful strategy to promote cardiovascular rehabilitation utilization
is systematic referral with a patient-provider discussion.
This study
investigated: (i) the elements of patient-provider discussions related to patient
cardiovascular rehabilitation enrollment, and (ii) the frequency and correlates
of these discussion elements. DESIGN: This was a prospective study
of cardiovascular patients and their healthcare providers. Discussions about
"secondary prevention" were audio-recorded. Utterances were coded using the Roter
Interaction Analysis System. Two months later, cardiovascular rehabilitation
enrollment was ascertained. RESULTS: Discussions between 26 healthcare providers
and 50 patients were recorded, of whom 27 (54.0%) enrolled in cardiovascular
rehabilitation. Participants were significantly more likely to enroll in
cardiovascular rehabilitation when their healthcare providers offered less
reassurance and optimism (odds ratio (OR) = 0.81), and when the patient asked
more questions related to lifestyle (OR = 4.98).
These were not common.
CONCLUSION: While caution is warranted due to the number of comparisons
undertaken such that associations observed may be chance associations, these
novel findings suggest that not overstating the beneficial effects of acute
treatment, and allowing patients more time to ask questions about needed
lifestyle changes should be investigated in future research.

Langue : ANGLAIS