Greater cardiac rehabilitation exposure and completion were significantly associated with higher overall disease management knowledge (P<0.01), which correlated with better heart-health behaviors.
Observational (n=4,309)
Yes
Does phase II outpatient cardiac rehabilitation improve disease management knowledge and health behaviors in patients with cardiovascular disease?
Cardiac rehabilitation participation globally is associated with high disease management knowledge, which correlates with improved heart-health behaviors.
p-value: p=<0.01
Abstract Background/Introduction Cardiovascular diseases (CVD) remain a leading cause of morbidity and mortality worldwide, with an increasing prevalence in low- and middle-income countries (LMICs). Cardiac rehab (CR) fosters disease management knowledge critical for empowering patients to achieve sustained secondary prevention. Purpose To investigate: (1) CVD management knowledge following CR, including variations by region, country income classification, and patient sociodemographic and clinical characteristics; (2) the association of post-CR knowledge with the number of CR sessions completed and setting of CR delivery; and (3) whether domain-specific knowledge post-CR is associated with corresponding health behaviors. Methods Secondary analysis of ICCPR’s International Cardiac Rehabilitation Registry (ICRR) data (to May 2024) was conducted for this prospective observational study. Eligible patients included those receiving phase II outpatient CR, with pre-program assessment completed at least 6 months prior. Knowledge was assessed via patient report at follow-up/post-program in 9 domains (y/n), as well as heart-health behaviors and work status. Programs reported CR use, functional capacity, and CV risk factors. Results 4,309 patients (mean age 60.2±32.2, 79% male) were included, from 20 programs, with 3,729 (86.5%) patients having any follow-up data (n=2,342 completed CR). Overall knowledge was high (90.0%), and greatest with regard to return to life roles, cardiac medications, and knowing care plan sent to primary (Figure 1). Overall knowledge varied significantly by country income classification (p0.001), with lower knowledge levels observed in lower-middle-income countries. It also varied by region (p0.001) with the highest overall knowledge scores observed in the Western Pacific, particularly in return to life roles, as well as lipid and blood pressure control, while the lowest scores were found in the African region, notably in lipid control, nutrition, and chest pain response (Figure 1). Male sex and higher educational attainment were associated with greater overall knowledge (both p0.05). CR completion and greater sessions attended correlated with higher knowledge (p0.01), particularly with hybrid delivery (p0.001). Knowledge in specific domains correlated with applicable health behaviors: nutrition knowledge was associated with greater fruit and vegetable intake (p0.01), medication knowledge with adherence (p0.05), and exercise knowledge with physical activity (p0.01). Conclusion(s) CR participants in diverse settings globally have high disease management knowledge, with variations based on regional, economic, and patient-level factors. Greater CR exposure was associated with higher knowledge acquisition, particularly in in-person models. Knowledge was associated with corresponding heart-health behaviors, which can support optimal patient outcomes.Figure 1
Ghisi et al. (2025) conducted an observational in Cardiovascular diseases (n=4,309). Cardiac rehabilitation was evaluated on Overall disease management knowledge (p=<0.01). Greater cardiac rehabilitation exposure and completion were significantly associated with higher overall disease management knowledge (P<0.01), which correlated with better heart-health behaviors.