Patients’ Care Transition in Cardiac Rehabilitation: A Scoping Review on Facilitators and Challenges Related to Referral and Enrolment

Abstract

Background. Despite existing evidence on the efficacy of cardiac rehabilitation (CR), programs are underutilized. Factors affecting referral and enrolment in hospital-based CR were identified; however, research into factors affecting referral and enrolment in community-based CR is lacking. Aim. The purpose of this scoping review is to identify and synthesize facilitators and challenges in the transition of patient care from hospital to community healthcare services and how they influence CR referral and enrolment. Method. PubMed, Embase, CINAHL, Scopus, ProQuest, and Web of Science databases were searched for relevant publications. The data were analysed using thematic analysis by Braun and Clarke. The study followed the PRISMA extension for scoping reviews and the Joanna Briggs Institute’s model. Result. In total, 36 studies were included in this analysis. The results show that facilitators and challenges for referral and enrolment in CR form a complex interaction. Factors influencing referral and enrolment may be setting-dependent or -independent. However, each setting may influence the entire transition. Conclusion. The patient decision-making process regarding CR may begin in the hospital, indicating that this period is the right time to encourage CR enrolment. To support patient transition, healthcare professionals at hospitals require knowledge of CR and the ability to prioritize patient support. Offering an initial meeting at a local site may decrease patient prejudice and facilitate enrolment.