Is There an Association between Attending Cardiac Rehabilitation Program and Health-related Quality of Life among Patients in Qatar?

Abstract

Background: Cardiovascular Disease (CVD) is the primary cause of death worldwide and in Qatar. More patients with CVD are living than before due to medical advancements. Therefore, there is an urgent need for secondary prevention strategies. Cardiac rehabilitation (CR) is a secondary prevention model of care for the management of CVD. Participation in CR programs is effective in improving health related quality of life (HRQOL), reducing cardiovascular mortality, morbidity, and hospital readmissions. Aim: This study aimed to explore the association between attending at least the median number of CR sessions and change in HRQOL among patients in Qatar. Methods: This is a retrospective cohort study that included all patients who were enrolled in the CR program in Qatar from (January 2013 to October 2017), with a total of 433 patients. Secondary data were extracted from patients’ records before the CR program (pre-CR) and at patient discharge (post-CR). The SF-36 instrument was used to assess HRQOL among patients. The four scales of HRQOL that were assessed are physical functioning, social functioning, emotional well-being, and general health. Results: The study involved 396 (91.4%) males; the mean age was 52.7±9.8 (SD) years. There was a statistically significant association between attending at least the median number of CR sessions and change in physical functioning scores (95% CI=8.85-29.11/ p-value=0.002), change in social functioning scores (95% CI=0.04 19.38/ p-value=0.04), change in emotional well-being scores (95% CI= 1.92-22.13/ p value=0.02), and change in general health scores (95% CI=0.38-16.42/ p-value= 0.03), as compared to attending less than the median number of sessions. The models adjusted for age, gender, comorbidities, level of risk, depression, and baseline HRQOL scores. Moreover clinically significant associations were found between attendance and improvement in physical functioning, social functioning, emotional well-being, and general health, effect sizes= (0.27, 95% CI= 0.11-0.47), (0.29, 95% CI= 0.11-0.47), (0.33, 95% CI= 0.17-0.48), (0.35, 95% CI= 0.21-0.50), respectively. Conclusion: CR program improved HRQOL, i.e., physical functioning, social functioning, emotional well-being, and general health. Therefore, there is a need to promote CR utilization among cardiac patients and to implement strategies to keep patients in programs. These findings could motivate policymakers to expand CR program capacity, as the sole program in Qatar