Factores relacionados con la no adherencia a la rehabilitación cardiaca en pacientes con insuficiencia cardiaca

Abstract

Introduction

In heart failure, cardiac rehabilitation has been recommended as an intervention strategy that improves functional capacity, health-related quality of life and survival. However, adherence to these programs is low. The objective was to determine the factors related to non-adherence to cardiac rehabilitation in patients with heart failure in Colombia.

Method

Observational and retrospective study. Patients with heart failure were linked in a clinic in Colombia, adherence to cardiac rehabilitation was measured with ≥ 80% of scheduled sessions. Sociodemographic and clinical variables, functional aerobic capacity (Sit to Stand and 6-minute walk test), Duke Activity Status Index (DASI), quality of life Minnesota Living with Heart Failure Questionnaire (MLFHQ) and depression Patient health questionnaire 9 (PHQ-9) were taken into account.

Results

300 patients were linked with heart failure with age 63.16 ± 12.87; men 194 (64.7%). Adherence to cardiac rehabilitation was 66.67%, there were statistically significant differences between the groups in arterial hypertension, LVEF, cholesterol, LDL, triglycerides, SBP, DBP, distance traveled, VO₂e, METs, DASI and PHQ-9 P ≤ .05. The logistic regression model adjusted for sex and age showed OR for non-adherence to CR arterial hypertension 2.23 [1.22-4.07], LDL outside of goals 2.15 [1.20-3.88], triglycerides outside goals 2.34 [1.35-4.07], DASI < 4METs 2.38 [1.04-5.45] and PHQ-9 1.06 [1.00-1.12].

Conclusion

High blood pressure, LDL, triglycerides, DASI and depression with the PHQ-9 questionnaire are related factors for not having adherence to cardiac rehabilitation in patients with heart failure.