Factors affecting program completion in phase II cardiac rehabilitation.

Background: Completion of a cardiac rehabilitation (CR) program post cardiac disease event promotes successful recovery and subsequent cardiovascular health. Attrition rates for CR programs have been reported as high as 65%. Little is known about the attrition population.

Purpose: The purpose of this study was to describe demographic and clinical variables associated with non-completion of CR and to identify factors that led to attrition.

Methods: A comparative retrospective survey design was used to identify differences in demographic and clinical variables between patients who completed CR and those who did not. Prospectively, CR participants who dropped out received follow-up calls to identify reasons for program cessation.

Results: Demographic variables were not significantly different between the attrition group and the control group. Having a normal ECG during a pre-program stress test and having higher levels of pre-program stress were significant for the attrition group. The most common reason for dropping out was physical health problems. Other influential factors included patients' perception that the exercise component of the program was too difficult and personal perceptions and reactions to the program.

Implications: Patients entering CR who present in better physical risk categories with higher home or occupational stress levels may be at risk for dropping out. CR staff should monitor patients early for personal reactions to the program along with their response to physical exercise in order to address issues that promote program attrition.