AWARENESS AND REFERRAL RATES OF CARDIAC REHABILITATION AMONG INTERNAL MEDICINE RESIDENTS IN A COMMUNITY SETTING: A MULTICENTER ANALYSIS

Therapeutic Area

Rehabilitation

Background

In the United States, The Centers for Medicare & Medicaid Services and most insurers authorize coverage for Cardiac Rehabilitation (CR) services for patients with stable chronic HF with LVEF ≤35% and NYHA functional class II to IV symptoms despite six weeks of treatment with optimal HF therapy. CR has a Class 1 Recommendation in the current American College of Cardiology/American Heart Association guideline for managing HF. Community hospitals deal with most of the above two indications, and little data exists about the referral processes in such places.

Methods

A questionnaire regarding cardiac rehabilitation, inquiring about internal medicine residents' awareness of indications, components, outcomes, and referral practices, was sent to 5 different community-based institutions. The information was collected anonymously and later analyzed in statistical software.

Results

Out of 136 residents, there was more or less equal distribution among the 3 PGY years, with the majority responding of having a cardiac catheterization lab and acknowledging recurrent heart failure admissions to their institutions. Varied responses were received regarding cardiac rehab availability at respective institutions. Surprisingly, despite somewhat adequate knowledge regarding cardiac rehabilitation's indications, components, and outcomes, only 28.68 % acknowledged routine CR referral. Referral rates increased with increasing training years. Further trends are seen in Table 1, Table 2, and Table 3.

Conclusions

Despite numerous studies highlighting the importance of physician referrals for cardiac rehabilitation enrollment, there is limited data on internal medicine residents' knowledge and referral practices. This is pivotal as they often manage a significant portion of patients with acute coronary syndromes and heart failure exacerbations in a community setting. Further research is needed to uncover disparities and improve cardiac rehabilitation utilization in community-based healthcare settings.