Background:

Cardiac rehabilitation (CR) practitioners recognize that patient centered (POs) outcomes are important measurements of success. However there is a lack of consensus regarding the prioritization of POs and the optimum methodology for their measurement. This research was designed to first identify then rate POs and ultimately rank measurements tools used in their evaluation through the use of the Delphi Technique, a widely recognized and effective tool to narrow general inquiry categories to succinct and specific questions that may be accurately assessed.

Methods:

Two hundred experts (AACVPR Fellows) in CR were surveyed by mail with 3 iterations of a Delphi questionnaire to determine short term (ST) and long term (LT) patient indicators of success in CR. Fifty-six respondents rated categories of patient success and ranked importance of methods of assessment in each category.

Results:

Four significant outcome themes were identified from common choice indicators; disease risk management, psychological well-being, exercise adherence, and increased work capacity. Disease risk management ranked highest with CAD risk factors and methods of measurement and tracking remaining consistent over time. There was relative lack of support for anthropometric evaluation and weight management. Second in importance was psychosocial well-being. Evaluating QOL, sense of well-being and degree of depression rated above social activity and social support measures. Exercise adherence respondents rated evidence of increased ADLs, weekly aerobic exercise and commitment to a home exercise regimen higher than recreational, strength training and organized maintenance (Phase III) activities. Improvement and maintenance of work capacity were highly rated ST outcomes but their rating decreased markedly for LT analysis giving way to self reported maintenance of home and work activities.

Conclusion:

This group of experts identified outcome indicators and their order of importance in evaluating LT & ST patient success in CR and suggested measurement modalities and instruments suitable for assessment.