Prediction of Patient Nonadherence with Home-Based Exercise for Cardiac Rehabilitation: The Role of Perceived Barriers and Perceived Benefits,

Background.The aim of this study was to determine whether cardiac patientsʹ perceptions of the barriers to and benefits of home exercise while in hospital and 6 weeks after discharge are predictive of nonadherence with regular home exercise 6 months after discharge from hospital. Methods.A prospective longitudinal study of 459 patients age 75 years or less and discharged from any of six public hospitals in the Lower Hunter Region of New South Wales, Australia, with a diagnosis of acute myocardial infarction or angina was conducted. Results.Multivariate logistic regression analysis, using data provided by 281 (61.2%) patients, showed that cardiac patientsʹ perceptions of the benefits of and the physical environment and time barriers to home exercise while in hospital were predictive of nonadherence with regular home exercise 6 months after discharge from hospital, after adjustment for potential confounders. Six weeks after discharge from hospital, patientsʹ perceptions of the enjoyment and time barriers to home exercise were predictive of nonadherence at follow-up, after adjustment for potential confounders. Conclusions.Cardiac patientsʹ perceptions of the barriers to and benefits of home exercise may be modifiable sources of nonadherence. A randomized controlled trial is required to confirm and extend upon these findings.