Patient Preferences for Type of Community-Based Cardiac Rehabilitation Programme

Introduction: Cardiac rehabilitation (CR) improves mortality, morbidity, unplanned hospital admissions and quality of life of cardiovascular patients. However, its uptake is poor especially in the hospitals due to long travel distances and office hours constraints. Community-based CR is a possible solution.
Objectives: To understand the community-based CR type preferred, and identify patient characteristics associated with certain programme combination.
Methods: A cross-sectional survey was administered to randomized list of patients with or at risk for cardiovascular diseases at the Singapore Heart Foundation. Participants were presented with nine hypothetical choice sets and asked to choose only one of the two combinations of programme attributes in each choice sets. Attributes explored include support group presence, cash incentives, upfront deposit and out-of-pocket cost. Chi-square test and logistic regression was conducted to understand the characteristic associated with the preferred CR combination.
Results: Choice 1A, 6A and 7B were most preferred. Chinese participants are more likely to choose Choice 6A (similar to 6B except for physiotherapist presence, no deposit/out-of-pocket cost) over 6B, while patients with Hyperlipidemia are less likely (Odds-Ratio 0.42; 95% Confidence-Interval 0.21-0.80, p=0.009). Patients with more than 3 bedrooms in their house are less likely to choose Choice 7A (similar to 7B except for physiotherapist presence but less equipment) over 7B.
Conclusion: This is the first study to explore patients’ preference for different types of community CR in Asia. Richer patients prefer physiotherapist presence and are willing to settle for less equipment. Our study could serve as a guide for future community CR programmes.