Abstract 4369005: Self Reported Importance of “Being Active” Associated with Better Physical Outcomes in Cardiac Rehab

Abstract

Background: Improvement in physical function is related to improved survival for patients with cardiovascular disease and an important goal when undergoing cardiac rehabilitation (CR). Little is known about how patients' values reported at CR intake may relate to patients’ motivation to effect behavior change and improvement in CR outcomes. Our study aims to determine how patients’ personal values affect CR outcomes. Methods: We completed a retrospective chart review of 720 patients who completed a university-affiliated CR program between Oct 2023 and Sept 2024. Patients were asked to rank their top three personal values from a predefined list of 18 options at CR intake. At CR entry and discharge, all participants completed assessments in CR outcomes: maximal effort stress test (METs), anxiety (GAD-7), depression (PHQ-9), and quality of life (RAND SF-36). Outcomes included change in stress test, (GAD-7), (PHQ-9), (RAND SF-36), number of sessions attended and weight loss. Patients were grouped based on their most important personal value. Differences in outcomes were compared between groups using Pearson’s Chi-square test for categorical and one-way ANOVA for continuous variables. Multivariate logistic regression adjusting for demographics and comorbidities determined the independent predictors of change in functional status (METs). Results: Of 720 CR completers, mean age (SD): 65.85 (11.98), female 30.04%, non-white 21.59%, 28.65% were of AACVPR high risk. Patients who ranked “being active” as their most important personal value had the highest net improvement in fitness mean (SD) 1.66 (1.29) METs (p= 0.05) and a trend towards the best improvement in SF36 Physical function scores: mean (SD) 7.4 (7.83) (p= 0.07). No significant difference was found in other CR outcomes or number of sessions attended mean (SD): 24.45 (10.57). Logistic regression showed that ranking “being active” as the most important value was the only independent predictor associated with improvement in fitness (p= 0.043). Conclusion: Our study showed personal values at intake to have a significant impact on CR outcomes, specifically related to fitness and should be considered when counseling CR patients. Knowledge of what values motivate CR patients may help tailor patient education and counseling to optimize enrollment, and adherence in CR. Future randomized studies are planned to confirm these findings.