Investigating the Influence of the Shared Decision-Making Perception on the Patient Adherence of the Home- and Exercise-Based Cardiac Rehabilitation After Percutaneous Coronary Intervention

BACKGROUND: In 2016, the Global Burden of Disease study pointed out that cardiovascular disease (CVDs) were the most common causes of death and accounted for the largest disease burden worldwide. Percutaneous coronary intervention (PCI) is one of the main treatments for coronary artery disease (CAD). Moreover, home- and exercise-based cardiac rehabilitation (CR) is of great importance for improving the prognosis of patients undergoing PCI. However, poor adherence to CR remains a challenging problem in these patients. AIM: This study aimed to investigate the current status of adherence to home- and exercise-based CR in patients undergoing PCI and to explore the factors affecting patient adherence to home- and exercise-based CR. METHODS: This study was a prospective longitudinal survey that included 300 patients who met the established criteria. The selected patients completed a pre-hospital discharge questionnaire, which targeted factors that may affect patient adherence to home- and exercise-based CR. All patients were followed up 1 month after the discharge from hospitals. RESULTS: This study analyzed 283 questionnaires and found that only 64.66% of patients had good adherence to home- and exercise-based CR. Eight independent variables, namely, shared decision-making (SDM), age, dimension of risk factors, predisposing factors, treatment methods, secondary prevention in the Perceived Knowledge Scale for CAD, and dimension of life and emotional management in the Scale of Self-Management with Coronary Artery Disease, were identified as the main factors affecting patient adherence to home- and exercise-based CR, which explains 88.9% variation (Nagel kerke R(2) = 0.889). CONCLUSION: Patients who underwent PCI had poor adherence to home- and exercise-based CR. Age, SDM, knowledge about CAD, and self-management behavior were identified as independent factors affecting patient adherence to CR after PCI.