Role of Case Management for Improving Cardiac Rehabilitation Participation in Women: A RANDOMIZED CONTROLLED TRIAL

PURPOSE: Despite the benefits, cardiac rehabilitation (CR) is underutilized, particularly in women. Case management (CM) has been shown to reduce the risk of cardiovascular disease and improve health outcomes. The purpose of this study was to assess the effects of early CM added to electronic referral and a CR liaison (usual care [UC]) on increasing CR participation rate and adherence in women. METHODS: A total of 109 female participants enrolled in the 4-month study; 56 were randomized to UC, while 53 were assigned to the intervention of CM. Demographic, psychosocial, and clinical data were obtained. Statistical methods included chi-square and nonpaired t-tests. A P value <.05 was used to determine significance. Within the whole sample, for those who attended 1 or more sessions of CR, univariate regressions were conducted to test associations between participant characteristics and number of sessions attended. RESULTS: Participation rates (number attending at least 1 CR session) were similar between CM versus UC (77% vs 77%, respectively; P = .9). Furthermore, no differences were seen in number of CR sessions attended between groups (20.2 for CM vs 17.3 for UC, P = .7). Within participants who attended at least 1 session of CR, current smoking, anxiety, depression, cardiac-specific quality of life, and perceived social support were all significantly associated with number of sessions attended (all P < .05). CONCLUSION: When added to electronic referral with a CR liaison, CM did not improve CR participation or adherence in women. Continued efforts are needed to develop specific strategies to increase utilization of CR in women.