Barriers to Engagement in Chronic Heart Failure Rehabilitation

An Australian Survey

Katie Palmer, Kelly-Ann Bowles, Rebecca Lane, Julia Morphet

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: While exercise has been shown to improve quality of life and physical function and reduce hospital admission rates in people with chronic heart failure (CHF), engagement is poor in condition specific rehabilitation programs. This project aims to identify barriers to engagement in rehabilitation, strategies to address these, and comprehensively detail CHF rehabilitation practise in Australia. Methods: An online survey was emailed to all cardiac and chronic heart failure rehabilitation programs in Australia utilising a publicly available database. Results: The survey was completed by 165 respondents: Australian Capital Territory (ACT) = 4, New South Wales (NSW) = 49, Northern Territory (NT) = 2, Queensland (Qld) = 23, South Australia (SA) = 12, Tasmania (Tas) = 2, Victoria (Vic) = 37, Western Australia (WA) = 12, including metropolitan (37%), regional (47%) and remote (9%) locations. Common barriers were themed into four areas: poor condition-specific health literacy, lack of medical professional support, interrupted health care systems, and personal and external deterrents. Strategies to improve engagement and attendance focussed mostly on the patient, with few strategies aimed at improving patient and health professional knowledge and referral processes. Programs generally appeared to follow current Australian Heart Foundation recommendations for CHF rehabilitation. Conclusions: This survey identifies common barriers that need to be addressed to improve engagement and attendance levels in CHF rehabilitation programs. While patient barriers are already being addressed, strategic planning needs to occur to address poor health literacy including for medical and health professionals, improved flow through the health care system and improving the flexibility of program delivery. Adaptation of home-based and tele-rehabilitation can help with this, while education and advertisement to patients and potential referrers needs to start early in the disease journey.

Original languageEnglish
Number of pages8
JournalHeart Lung and Circulation
DOIs
Publication statusAccepted/In press - 13 Aug 2019

Keywords

  • Australia
  • Community
  • Engagement
  • Exercise
  • Heart failure
  • Rehabilitation

Cite this

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title = "Barriers to Engagement in Chronic Heart Failure Rehabilitation: An Australian Survey",
abstract = "Background: While exercise has been shown to improve quality of life and physical function and reduce hospital admission rates in people with chronic heart failure (CHF), engagement is poor in condition specific rehabilitation programs. This project aims to identify barriers to engagement in rehabilitation, strategies to address these, and comprehensively detail CHF rehabilitation practise in Australia. Methods: An online survey was emailed to all cardiac and chronic heart failure rehabilitation programs in Australia utilising a publicly available database. Results: The survey was completed by 165 respondents: Australian Capital Territory (ACT) = 4, New South Wales (NSW) = 49, Northern Territory (NT) = 2, Queensland (Qld) = 23, South Australia (SA) = 12, Tasmania (Tas) = 2, Victoria (Vic) = 37, Western Australia (WA) = 12, including metropolitan (37{\%}), regional (47{\%}) and remote (9{\%}) locations. Common barriers were themed into four areas: poor condition-specific health literacy, lack of medical professional support, interrupted health care systems, and personal and external deterrents. Strategies to improve engagement and attendance focussed mostly on the patient, with few strategies aimed at improving patient and health professional knowledge and referral processes. Programs generally appeared to follow current Australian Heart Foundation recommendations for CHF rehabilitation. Conclusions: This survey identifies common barriers that need to be addressed to improve engagement and attendance levels in CHF rehabilitation programs. While patient barriers are already being addressed, strategic planning needs to occur to address poor health literacy including for medical and health professionals, improved flow through the health care system and improving the flexibility of program delivery. Adaptation of home-based and tele-rehabilitation can help with this, while education and advertisement to patients and potential referrers needs to start early in the disease journey.",
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Barriers to Engagement in Chronic Heart Failure Rehabilitation : An Australian Survey. / Palmer, Katie; Bowles, Kelly-Ann; Lane, Rebecca; Morphet, Julia.

In: Heart Lung and Circulation, 13.08.2019.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Barriers to Engagement in Chronic Heart Failure Rehabilitation

T2 - An Australian Survey

AU - Palmer, Katie

AU - Bowles, Kelly-Ann

AU - Lane, Rebecca

AU - Morphet, Julia

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Y1 - 2019/8/13

N2 - Background: While exercise has been shown to improve quality of life and physical function and reduce hospital admission rates in people with chronic heart failure (CHF), engagement is poor in condition specific rehabilitation programs. This project aims to identify barriers to engagement in rehabilitation, strategies to address these, and comprehensively detail CHF rehabilitation practise in Australia. Methods: An online survey was emailed to all cardiac and chronic heart failure rehabilitation programs in Australia utilising a publicly available database. Results: The survey was completed by 165 respondents: Australian Capital Territory (ACT) = 4, New South Wales (NSW) = 49, Northern Territory (NT) = 2, Queensland (Qld) = 23, South Australia (SA) = 12, Tasmania (Tas) = 2, Victoria (Vic) = 37, Western Australia (WA) = 12, including metropolitan (37%), regional (47%) and remote (9%) locations. Common barriers were themed into four areas: poor condition-specific health literacy, lack of medical professional support, interrupted health care systems, and personal and external deterrents. Strategies to improve engagement and attendance focussed mostly on the patient, with few strategies aimed at improving patient and health professional knowledge and referral processes. Programs generally appeared to follow current Australian Heart Foundation recommendations for CHF rehabilitation. Conclusions: This survey identifies common barriers that need to be addressed to improve engagement and attendance levels in CHF rehabilitation programs. While patient barriers are already being addressed, strategic planning needs to occur to address poor health literacy including for medical and health professionals, improved flow through the health care system and improving the flexibility of program delivery. Adaptation of home-based and tele-rehabilitation can help with this, while education and advertisement to patients and potential referrers needs to start early in the disease journey.

AB - Background: While exercise has been shown to improve quality of life and physical function and reduce hospital admission rates in people with chronic heart failure (CHF), engagement is poor in condition specific rehabilitation programs. This project aims to identify barriers to engagement in rehabilitation, strategies to address these, and comprehensively detail CHF rehabilitation practise in Australia. Methods: An online survey was emailed to all cardiac and chronic heart failure rehabilitation programs in Australia utilising a publicly available database. Results: The survey was completed by 165 respondents: Australian Capital Territory (ACT) = 4, New South Wales (NSW) = 49, Northern Territory (NT) = 2, Queensland (Qld) = 23, South Australia (SA) = 12, Tasmania (Tas) = 2, Victoria (Vic) = 37, Western Australia (WA) = 12, including metropolitan (37%), regional (47%) and remote (9%) locations. Common barriers were themed into four areas: poor condition-specific health literacy, lack of medical professional support, interrupted health care systems, and personal and external deterrents. Strategies to improve engagement and attendance focussed mostly on the patient, with few strategies aimed at improving patient and health professional knowledge and referral processes. Programs generally appeared to follow current Australian Heart Foundation recommendations for CHF rehabilitation. Conclusions: This survey identifies common barriers that need to be addressed to improve engagement and attendance levels in CHF rehabilitation programs. While patient barriers are already being addressed, strategic planning needs to occur to address poor health literacy including for medical and health professionals, improved flow through the health care system and improving the flexibility of program delivery. Adaptation of home-based and tele-rehabilitation can help with this, while education and advertisement to patients and potential referrers needs to start early in the disease journey.

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KW - Community

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M3 - Article

JO - Heart Lung and Circulation

JF - Heart Lung and Circulation

SN - 1443-9506

ER -