Poor attendance for women in cardiac rehab sessions, finds York U/UHM study

Even with cardiac rehab (CR) programs tailored to their needs, women heart patients miss more than half of the sessions prescribed to them, according to a joint study by York University and the University Health Network (UHN).

Sherry Grace
Sherry Grace

Cardiac rehab is an outpatient program that educates participants on their medical condition and requires them to do structured exercise to better manage their disease. Traditional programs are co-ed, but home-based models are also offered, and more recently women-only programs have been developed.

However, Professor Sherry L. Grace in York’s University’s Faculty of Health says women may adhere more to and benefit more from CR programs if they are able to make their own choices about which program model they attend.

“Participating in a cardiac rehab program greatly reduces death and hospitalization, as well as helps in improving the quality of life for heart patients,” says Grace, who is also a senior scientist at UHN. “Unfortunately, many patients do not use these proven services, and women are much less likely than men to access them and fully participate once they do.”

To test what might improve female heart patients’ adherence to cardiac rehab, Grace and her colleagues compared women’s participation in one of the three program models offered. Study participants were randomly assigned to either a mixed-sex (co-ed) program, a women-only program or a home-based program model. The researchers recruited women from six cardiac care facilities in Ontario and referred them to one of these three available CR models.

The study, CR4HER, published in Mayo Clinic Proceedings, assessed adherence to the program as well as improvements in exercise capacity, which is strongly linked to better survival.

Researchers found that women attended just over half of the 24 sessions offered, regardless of the model they were assigned to. However, the participants achieved significant improvements in their exercise capacity.

“The results suggest that women should be encouraged to participate in cardiac rehab, offering them the program model of their choice,” says Liz Midence, lead author and PhD candidate at York U. “We should inform women of the benefits of cardiac rehab and use all the tools at our disposal to promote their full participation.”

Midence notes that women might have limitations, including taking time off from caregiving responsibilities, and access to transportation.

The findings suggest that women may be more likely to fully participate in a home-based program, where they can be supported by the cardiac rehab staff by phone at a convenient time for them.

According to researchers, some women may also feel they need to attend a centre to stay motivated, but feel uncomfortable exercising with men. For these patients, being able to access a women-only program may mean they are more likely to keep coming back and achieve the greatest gains in their heart health.