Improving Cardiac Rehabilitation Adherence in Patients With Lower Socioeconomic Status: A Randomized Clinical Trial
Authors' conclusion
In this randomized clinical trial, financial incentives improved cardiac rehabilitation adherence in a population with higher risk and lower SES with additional benefit from adding case management.
Study context
- Population
- Patients with lower socioeconomic status (SES) and a cardiac rehabilitation-qualifying diagnosis (MI, CABG, PCI, heart valve replacement/repair or stable systolic HF)192 analysed
- Participants
- 209 patients
- Comparison
- Case management and/or financial incentives vs usual care
- Usual caren = 36reference
- Case managementn = 51
- Financial incentivesn = 53
- Case management plus financial incentivesn = 52
- Primary endpoint
- Cardiac rehabilitation adherence (proportion completing ≥30 sessions)
Methodological detailsassessor-blinded, stratified randomisation, 2:3:3:3 allocation, 3 centres (1 university, 2 community hospitals), Enrolment December 2018 to December 2022; 1-year follow-up, Interventions in place for 4 months
- Assessor-blinded
- Stratified randomisation
- 2:3:3:3 allocation
- 3 centres (1 university, 2 community hospitals)
- Enrolment December 2018 to December 2022; 1-year follow-up
- Interventions in place for 4 months
Primary result
As reported in the abstract
Completing ≥30 cardiac rehabilitation sessions
Adjusted odds ratio (95% CI)P value
Financial incentivesvs Usual care
5.1(1.5–16.7)
P = 0.01Case management plus financial incentivesvs Usual care
13.2(4.0–43.5)
P < 0.001Case management plus financial incentivesvs Case management
5.0(2.1–11.9)
P < 0.001Case management plus financial incentivesvs Financial incentives
2.6(1.2–5.9)
P = 0.02Further findings
Intervention uptake
- Earned at least some incentives (financial incentives conditions)
- 86 of 105 (82%)
- Completed initial needs assessment (assigned a case manager)
- 96 of 103 (93%)
Original publication
Improving Cardiac Rehabilitation Adherence in Patients With Lower Socioeconomic Status: A Randomized Clinical Trial. JAMA Intern Med. Published 1 September 2024. doi:10.
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