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Table 1 Barriers to cardiac rehabilitation

From: Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia

 

Barrier

Contributory factor

Healthcare Professional / Health Service related

Referral and access

Referral failure

Clinician awareness and recommendation, inadequate referral pathways, lack of a dedicated CR coordinator, vulnerable patient populations.

Program inflexibility

Accessibility, inflexible program hours, failure to meet individual needs, geographical location (distance, time and transport difficulties).

Program availability

Absence of local program, limited program places, fragmented funding, geographical location.

Patient related

Access to services:

Transport, work, social/family, distance, financial, geographical

Patient perception

Need, value, knowledge, futility, views of health system, financial considerations

Lack of motivation, or commitment or adherence

Lack of energy, functional impairment, vulnerable patients, smoking

Vulnerable patient populations:

Aboriginal, other ethnic minority populations, women, rural patients, older patients, comorbidities, socio-economically disadvantaged

Lack of support

Health Professionals, family, social

Type of cardiac event

Patients following AMI and PCI less likely to attend than CABG

  1. Key: AMI acute myocardial infarction, PCI percutaneous intervention, CABG coronary artery bypass graft