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STRATEGIES TO INCREASE CARDIAC REHABILITATION ENROLLMENT: A NARRATIVE REVIEW. Put your Title here. C Andraos, BSc 1 , R Britto, PT, PhD 2 N Suskin, MBChB 3 , & SL Grace, PhD 1,4. *.

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  1. STRATEGIES TO INCREASE CARDIAC REHABILITATIONENROLLMENT: A NARRATIVE REVIEW Put your Title here C Andraos, BSc1, R Britto, PT, PhD2 N Suskin, MBChB3, & SL Grace, PhD1,4 * 1York University, 2Federal University of Minas Gerais, 3London Health Sciences & Western, 4University Health Network ** Pre / Control Post / Intervention • Discussion • The interventions were most-commonly systematic referral, and early outpatient education or CR contact • All RCTs were positive (from 45 to 77% enrollment) • Odds ratios ranged from 1.49 to 4.85. • It is time to implement these strategies on a broad scale • Limitations • Only publications written in the English language were included • Did not consider quality • Potential publication bias • Rationale • Cardiovascular disease is one of the leading causes of morbidity and mortality in North America. • Cardiac Rehabilitation (CR) programs aid patients with recovery after cardiac events and/or procedures, and reduce mortality. • Unfortunately, CR programs are grossly under-utilized. • The last Cochrane review (Davies, 2010) of uptake interventions summarized the literature to 2008. 3 successful strategies were identified. • Method • Design: • Narrative review • Procedure • A limited literature search of publications between June 2008 to March 2013 was completed. • The following databases were searched: PubMed, Scopus, ProQuest, CINAHL and Embase. • Inclusion Criteria: • Based on the Cochrane Review (Davies et al., 2010), except non-randomized studies were also included. • Primary Outcome: • Patient enrollment in CR • Results • Ten studies were included, of which 3 were RCTs. • There was one null study (Mazzini), and one null strategy (Grace), and no negative findings. *** Figure. CR Enrollment Rates in Included Studies *** Cossette, 2012 - RCT Inpatient + Outpatient RN Education Grace, 2011§ Systematic Referral + Liaison Grace, 2012 Early Outpatient Education @ CR Systematic Referral prep-approved Intake Appointment Pre-Booked Higgins, 2008 Combination of 6 Interventions Mazzini, 2008 Systematic Referral – GWTG Mueller, 2009 - RCT Systematic Referral + Early Education Pack, 2013 - RCT Early CR Orientation Parker, 2011 Systematic Referral + Early Education Tiller, 2013† Systematic Referral + Early Education *** ** *** * 60 80 100 20 40 Enrollment (%) Conclusions CR discussions at the bedside, systematized referral (including pre-approval), and early outpatient contact significantly increased patient enrollment in CR, to often greater than 80%. • Objective • To qualitatively review the literature on interventions to increase CR enrollment, since the Cochrane analysis Johnson, 2010 Nurse CR referral OR = 3.40, 95% CI:1.74-6.64*** † no inferential test performed;§ other strategies not shown, p<0.01 * p < 0.05; ** p < 0.01; *** p < 0.001

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