Work

Cardiac rehabilitation referrals and assessments for patients undergoing elective percutaneous coronary intervention: A secondary analysis using routinely collected health data

Year: 2026

Type: article

Abstract: Background Cardiac rehabilitation is a structured secondary prevention program delivered in three phases that aims to improve health outcomes, quality of life, and economic benefits for people with cardiovascular disease. Despite its proven effectiveness, participation in Phase II cardiac rehabilitation remains low due to a range of individual, clinical, logistical, and health‑system barriers. Aim Our study aimed to identify contemporary trends and factors associated with cardiac rehabilitation referrals and assessments for patients undergoing elective percutaneous coronary intervention. Methods We performed a secondary analysis using extracted data for all patients who underwent elective percutaneous coronary intervention between July 2014 and December 2021 among six public hospitals in Queensland, Australia. Results Of 3081 patients, 1845 (59.9%) had cardiac rehabilitation referrals within 30 days of hospital discharge. Of the 1845 patients with a referral, 1022 (55.4%) underwent an initial assessment, and of those, 400 (39.1%) completed a final assessment. There was variation in the trends of referrals (declining from 69.7% to 57.1%), initial assessment (declining from 62.4% to 51.1%), and final assessment (increasing from 32.2% to 40.5%) across the study period. Those who stayed overnight were 10.2 times more likely to receive a referral than those who were discharged the same day. However, overnight stay was not a factor associated with completing the initial and final assessments. Discussion Cardiac rehabilitation participation showed decreasing referral and initial assessment rates, with slight improvement in final assessment completion. Although overnight stay strongly increased referral likelihood, discharge status did not influence engagement once patients entered the program. Conclusion Referral rates were moderate, and same-day discharge patients had lower odds of referral. More work is needed to understand barriers to referral, especially for same-day discharge patients. Also, strategies are required to promote sustained participation in cardiac rehabilitation activities.

Source: Collegian Journal of the Royal College of Nursing Australia

DOI: 10.1016/j.colegn.2026.01.005