Corresponding author: Mariya Prakash Jiandani
Copyright © 2023 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0.
Patient perceived barriers to phase II cardiac rehabilitation in patients with and
without percutaneous coronary angioplasty
Aarti Rathi and Mariya Prakash Jiandani
*
Physiotherapy School & Centre, Seth G S Medical College & KEMH, Parel, Mumbai 12, Maharashtra, India.
World Journal of Advanced Research and Reviews, 2023, 17(03), 883–889
Publication history: Received on 14 February 2023; revised on 25 March 2023; accepted on 27 March 2023
Article DOI: https://doi.org/10.30574/wjarr.2023.17.3.0484
Abstract
Context: Cardiac Rehabilitation is an accepted standard of care after any cardiac event and is considered a class ɪ
indication following myocardial infarction or revascularisation procedures. It aims at the reduction of cardiovascular
risk factors and improves quality of Life by promoting healthy behavior and an active lifestyle. However, despite its
proven benefits and need, it is highly underutilized. Hence this study aims to explore the barriers perceived by patients
who were conservatively treated and with percutaneous coronary intervention to attend outdoor cardiac rehabilitation
services.
Settings and Design: Observational study at the cardiology unit of a tertiary health care hospital.
Methods and Material: The barriers perceived by the patients were studied using the interview method using Cardiac
Rehabilitation Barrier Scale (CRBS). A complete enumeration sampling technique was used for the enrolment of
subjects. The primary outcome measure was to analyse the sub-questions of all four domains of CRBS and compare the
difference in the distribution of barriers between conservatively managed and PCI using the Mann-Whitney U test.
Results: 216 patients were enrolled, out of which 123 were managed conservatively and 93 underwent Percutaneous
Coronary Intervention. Lack of awareness about CR was found in 128 patients (59.25%), Distance and transportation
problems were found in 117 patients (54.16%) in the conservative group, and 101 patients in PCI (46.75%). Work
time conflict was observed in 117 patients (53.74%) in conservative and 93 patients (43.05%) in PCI. 84 patients
(38.8%) had low energy levels and 44 patients (20.36%) found exercising tiring and painful. Patients with PCI had
greater referral issues, cost issues, and low energy levels and found exercise tiring and painful (p< 0.005) than
conservatively managed.
Conclusions: Referral, Knowledge of CR, access to healthcare resources, and Work Time conflicts are perceived as major
barriers to Cardiac Rehabilitation. Additionally, higher Cost issues, Low Energy levels, and fear of exercising were
observed more in patients with PCI than in conservatively managed.
Keywords: Cardiac Rehabilitation; Barriers; Cardiac Rehabilitation Barrier scale; Coronary Artery Disease;
Percutaneous Coronary Intervention
1. Introduction
Cardiac Rehabilitation is an accepted standard of care after a cardiac event and is considered a class ɪ indication
following myocardial infarction or revascularisation procedures as recommended by numerous National Guidelines. It
aims at the reduction of cardiovascular risk factors improving Quality of Life by promoting healthy behavior and an