| 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 |