The impact of patient education on knowledge, attitudes, and cardiac rehabilitation attendance among patients with coronary artery disease

• Published in: Patient education and counseling 2021-12, Vol.104 (12), p.2969-2978
• Main Authors: Williamson, Tamara M., Rouleau, Codie R., Aggarwal, Sandeep G., Arena, Ross, Hauer, Trina, Campbell, Tavis S.
• Format: Article
• Language: English
• Subjects: Adult; Attitudes; Cardiac Rehabilitation; Coronary Artery Disease; Exercise Therapy; Female; Health Knowledge, Attitudes, Practice; Health Promotion; Humans; Knowledge; Male; Patient Compliance; Patient education; Patient Education as Topic
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2021.04.024

•We confirmed that patient education in cardiac rehabilitation improves knowledge.•Improvements in cardiac knowledge following education were sustained for 12-weeks.•Patients reported greater perceived need for cardiac rehabilitation following education.•Larger gains in cardiac knowledge may not translate to better exercise attendance.•Education in cardiac rehabilitation should target exercise intentions and attitudes. Patient education (PE) delivered during exercise-based cardiac rehabilitation (CR) aims to promote health behaviour change, including attendance at CR exercise sessions, by imparting knowledge about coronary artery disease (CAD) and improving CR-related attitudes. This study evaluated the impact of PE on aspects of patient motivation (i.e., CAD-related knowledge, attitudes towards CR) and exercise session attendance. Adults with CAD referred to a 12-week CR program were recruited. CAD knowledge, perceived necessity/suitability of CR, exercise concerns, and barriers to CR were assessed pre/post-PE, and at 12-week follow-up. CR exercise attendance was obtained by chart review. Among 90 patients (60 ± 10 years; 88% men), CAD knowledge and perceived necessity of CR improved pre- to post-PE; gains persisted at 12-weeks. Stronger pre-CR intentions to attend exercise sessions predicted greater attendance. Greater knowledge gains did not predict improvements in CR attitudes or exercise attendance. Whereas PE may be useful for improving knowledge and attitudes regarding CAD self-management, more formative research is needed to determine whether PE can promote CR attendance. Cardiac PE programs may be more successful in promoting exercise attendance if they target patients’ behavioural intentions to attend and attitudes toward CR, rather than focussing exclusively on imparting knowledge.