Cardiac Rehabilitation in a Tertiary Care Centre: Insights into Healthcare Professionals’ Knowledge, Attitudes and Referral Practices

Abstract Background: Cardiac rehabilitation (CR) is essential for improving recovery and reducing cardiovascular risks in patients with heart disease, yet its utilisation remains limited in tertiary care settings in India. The knowledge, attitudes and referral practices of healthcare professionals significantly influence CR implementation. This study examines these factors amongst healthcare professionals at various tertiary care centres. Materials and Methods: A cross-sectional survey was conducted amongst 299 healthcare professionals from various specialities in tertiary care centres using a digital questionnaire, designed based on validated CR literature and refined through expert content validity review. Convenience sampling was employed to collect data on demographics, CR awareness, attitudes, referral patterns and barriers. Quantitative data were analysed using descriptive statistics and logistic regression to identify predictors of referral behaviour, whereas qualitative responses underwent thematic analysis. Results: Seventy-three per cent of participants were familiar with CR, with 60% rating their understanding as moderate to high. Ninety-four per cent recognised CR’s importance for post-cardiac event recovery, but only 36% regularly referred patients to CR programmes. Logistic regression showed cardiologists (odds ratio [OR] = 4.2, 95% confidence interval [CI]: 2.1–8.4) and higher CR knowledge scores (OR = 1.7 per unit, 95% CI: 1.3–2.2) predicted frequent referrals. Major barriers included lack of awareness (79%), financial limitations (46%) and transportation challenges (43%). Conclusion: Despite positive attitudes towards CR, knowledge gaps and inconsistent referral practices persist in tertiary care centres. Targeted education, infrastructure improvements and institutional policies may enhance CR uptake, though findings from this small sample may not generalise broadly.