A nationwide survey on participation in cardiac rehabilitation among patients with coronary heart disease using health claims data in Japan

• Published in: Scientific reports Vol. 11; no. 1; pp. 20096 - 9
• Main Authors: Ohtera, Shosuke, Kato, Genta, Ueshima, Hiroaki, Mori, Yukiko, Nakatani, Yuka, Ozasa, Neiko, Nakayama, Takeo, Kuroda, Tomohiro
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 11.10.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4019; 692/700/228/491; Adult; Aged; Cardiac Rehabilitation - statistics & numerical data; Cardiovascular disease; Cardiovascular diseases; Coronary artery; Coronary Artery Bypass; Coronary artery disease; Coronary Artery Disease - rehabilitation; Coronary Artery Disease - therapy; Education; Exercise Therapy; Female; Follow-Up Studies; Health Plan Implementation; Heart surgery; Humanities and Social Sciences; Humans; Male; Middle Aged; multidisciplinary; Nutritional Support; Participation; Patient Education as Topic; Patient Participation - psychology; Patient Participation - statistics & numerical data; Percutaneous Coronary Intervention; Prognosis; Rehabilitation; Retrospective Studies; Science; Science (multidisciplinary); Surveys and Questionnaires; Japan
• DOI: 10.1038/s41598-021-99516-1
• ISSN: 2045-2322

Poor implementation and variable quality of cardiac rehabilitation (CR) for coronary heart disease (CHD) have been a global concern. This nationwide study aimed to clarify the implementation of and participation in CR among CHD patients and associated factors in Japan. We conducted a retrospective cohort study using data extracted from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Patients who underwent percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) in 2017–2018 were included. Aspects of CR were assessed in terms of (1) participation in exercise-based CR, (2) pharmacological education, and (3) nutritional education. Of 87,829 eligible patients, 32% had participated in exercise-based CR, with a mean program length of 40 ± 71 days. CABG was associated with higher CR participation compared to PCI (OR 10.2, 95% CI 9.6–10.8). Patients living in the Kyushu region were more likely to participate in CR (OR 2.59, 95% CI 2.39–2.81). Among patients who participated in CR, 92% received pharmacological education, whereas only 67% received nutritional education. In Japan, the implementation of CR for CHD is insufficient and involved varying personal, therapeutic, and geographical factors. CR implementation needs to be promoted in the future.