Rationale:

There is compelling evidence that a comprehensive cardiac rehabilitation and secondary prevention (CRSP) program reduces mortality, morbidity and improves quality of life in post myocardial infarction (MI), acute coronary syndrome (ACS), coronary artery bypass surgery (CABG) and coronary angioplasty patients (PTCA). However, less than 20% of eligible patients at our institution (LHSC) participate in a CRSP program. Although there are likely multiple reasons for this, anxiety due to a lack of knowledge of what to expect during the CRSP program has been noted as an important predictor for lack of participation. A possible solution to the lack of patient knowledge is the use of an informational videotape comprising an explanation of the CRSP program.

Objectives:

Primary - To compare the number of patients expressing intent to participate in a CRSP program between patients who viewed a brief introductory video about the CRSP program compared to those who did not. Secondary - To determine other patient variables that predict CRSP intent to participate.

Methods:

A randomized, single blind, interventional survey based clinical trial strategy was used. Patients admitted with MI, ACS, CABG or PTCA residing within a 1-hour radius of the LHSC CRSP program were approached to participate in the study. On the day before hospital discharge, consenting patients were randomized to one of two groups: videotape intervention or control. Initially, patients were not aware of the other group to which they were not randomized. Those in the videotape intervention group viewed a short informational video of LHSC's CRSP program before filling out surveys measuring intent to participate in CRSP along with other demographic, quality of life, psychological distress and functional capacity variables. Those in the control group were given a brief description of the CRSP program and asked to fill out the same surveys. After finishing the surveys, the existence of and the rationale behind two separate intervention and control groups were revealed to the patients.

Results:

Sixty-nine eligible patients were identified over a 6-week period. Of these, 56 patients consented to participate in the study and 100% reached study completion; with 27 subjects randomized to the videotape intervention and 29 subjects to the control condition. Viewing the informational videotape intervention significantly increased the number of subjects expressing intent to participate in the CRSP program compared with control (96% vs. 69% intent to participate, P = 0.012). None of the demographic, quality of life, psychological distress and functional capacity measures significantly affected intent to participate in CRSP.

Conclusions:

The use of an informational videotape increases intent to participate in a CRSP program and thus holds promise as a tool to increase CRSP participation. However, before this intervention is widely implemented, its impact on actual CRSP participation will need to be evaluated.

Section Description

For more information, contact Marilyn Thomas (204) 488-5854