10 Monitoring long term outcomes for patients adhering to supervised phase 4 exercise rehabilitation

<h3>Background</h3> Lifestyle based health promotion interventions in Cardiac Rehabilitation (CR) are directly influenced by participant adherence; however poor adherence is widespread, particularly over the long-term. Evidence suggests that the most promising approaches to promoting long-term adherence include plans to monitor and measure sustained behaviour change (NICE), and motivational interviewing (BACPR). <h3>Aim</h3> To explore the efficacy of long-term (phase 4) supervised exercise rehabilitation in patients with cardiovascular disease (CVD) in maintaining benefits achieved following supervised phase 3 core CR. <h3>Methods</h3> Patients attending a core phase 3 exercise rehabilitation programme attended an initial baseline assessment (A1), followed by a repeat assessment on completion of the programme (A2). To monitor long-term adherence to health behaviours we introduced a 6-month follow up assessment (A3). Using retrospective data from 2023/24, we compared 6-month follow up outcomes in patients attending supervised phase 4 exercise sessions (Group 1) with patients not attending supervised phase 4 exercise sessions (Group 2). Motivational interviewing techniques were used during each assessment. Outcomes included METS, DASI, HADS and body composition. <h3>Results</h3> 166 patients attended a 6-month follow up in 2023/24 after completing a core phase 3 exercise rehabilitation programme (Group 1 n = 81; Group 2 n = 85). Diagnoses reflected the national averages (NACR, 2019). There were no between-group differences at baseline assessment (A1), in outcomes on completion of the exercise programme (A2) and at 6-month follow up (A3). <h3>Conclusion</h3> Adherence to lifestyle changes is crucial for managing cardiovascular disease and improving quality of life. The results of this service evaluation suggest that the 6-month follow up appointment and/or the motivational interviewing techniques were the interventions that motivated patients to maintain behaviours, rather than the long-term supervised exercise rehabilitation sessions. Further research is needed regarding efficacy in reinforcing health-promoting modes of behaviour, differential indications for different patient groups, and cost-efficiency.