Focus Area: Adherence

Change concept, change idea, tools and resources.

Adherence strategies are about understanding patient characteristics that are predictive of program dropout and deploying strategies to encourage adherence.

Note: Change concepts are general notions that are useful in the development of more specific ideas for changes that lead to improvement. Change ideas are actionable, specific ideas or strategies for changing a process. Each change idea lists evidence- or practice-based tools and resources that can be adapted by or adopted in a health care setting to improve cardiac rehabilitation (CR) utilization.

Adherence: Change Concepts*

Change Idea:
Know the characteristics that are predictive of attendance and dropout to identify patients at particular risk, to offer extra support

Tools & Resources:

Case Study: University of Alabama at Birmingham—Increase Enrollment and Session Adherence [PDF – 290K]
Class Schedule: University of Alabama at Birmingham—Cardiopulmonary Rehabilitation [PDF – 536K]

Change Idea:
Incorporate motivational and financial incentives for meeting goals for session attendance

Tools & Resources:

AACVPR Cardiac Rehabilitation Adherence Strategy—Incorporating Motivational and Financial Incentives [PDF – 490K]
Case Study: University of Vermont Medical Center—Financial Incentives to Improve Cardiac Rehabilitation Attendance Among Medicaid Enrollees [PDF – 175K]

Change Idea:
Automate reminders and communication

Tools & Resources:

AACVPR Cardiac Rehabilitation Adherence Strategy—Use of Text Messaging and Mobile Applications [PDF – 510K]

Change Idea:
Connect enrolled patients with a graduate or phase 3 participant Patient Ambassador or “sponsor”

Tools & Resources:

Case Study: Miriam Hospital Center for Cardiac Fitness—Patient Ambassador Program [PDF – 297K]
Miriam Hospital Center for Cardiac Fitness—Patient Ambassador Program Guidelines [PDF – 108K]
Miriam Hospital Center for Cardiac Fitness—Patient Ambassador Program Invitation Flyer [PDF – 261K]
Miriam Hospital Center for Cardiac Fitness—Patient Ambassador Profile Sheet [PDF – 8K]
Miriam Hospital Center for Cardiac Fitness—Patient Ambassador Program Welcome Packet [PDF – 300K]
Miriam Hospital Center for Cardiac Fitness—Patient Ambassador Program Letter of Thanks [PDF – 101K]
Miriam Hospital Center for Cardiac Fitness—Patient Ambassador Program Evaluation Survey [PDF – 117K]

Bold font indicates CR programs that contributed content.

*If you would like more information about addressing specific factors that influence adherence, such as nutrition education, psychosocial counseling, and self-management approaches, please visit the AACVPR website.

Note: References for citations on this page can be found under Additional Resources and References.

Additional Focus Areas

Learn more about the other Cardiac Rehabilitation Change Package (CRCP) focus areas:

Page last reviewed: October 24, 2019

Content source: Division for Heart Disease and Stroke Prevention