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Research Letter |

Participation in Cardiac Rehabilitation Programs Among Older Patients After Acute Myocardial Infarction

Jacob A. Doll, MD1,2; Anne Hellkamp, MS1,2; P. Michael Ho, MD, PhD3,4; Michael C. Kontos, MD5; Mary A. Whooley, MD6,7; Eric D. Peterson, MD, MPH1,2; Tracy Y. Wang, MD, MHS, MSc1,2
[+] Author Affiliations
1Duke Clinical Research Institute, Durham, North Carolina
2Department of Medicine, Division of Cardiology, Duke University, Durham, North Carolina
3VA Eastern Colorado Health Care System, Denver
4Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora
5Department of Medicine, Division of Cardiology, Virginia Commonwealth University, Richmond
6San Francisco Veterans Affairs Medical Center, San Francisco, California
7Department of Medicine, Division of Cardiology, University of California, San Francisco, San Francisco
JAMA Intern Med. 2015;175(10):1700-1702. doi:10.1001/jamainternmed.2015.3819.
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This analysis of clinical data linked to Medicare claims finds the cardiac rehabilitation rate for older patients after acute myocardial infarction is low in the United States and suggests efforts be made for increasing referrals, and addressing attendance barriers, to rehabilitation sessions.

A recent clinical practice guideline strongly supports cardiac rehabilitation for patients after acute myocardial infarction (AMI).1 Cardiac rehabilitation programs are multifaceted outpatient interventions that include individualized exercise regimens, health education, and structured support focused on cardiovascular risk reduction and medication adherence.2 Patients typically attend 2 to 3 sessions weekly for up to 36 sessions. Cardiac rehabilitation improves survival after AMI3 and is associated with improvements in lifestyle, functional capacity, and quality of life for older adults.4,5 Despite these benefits, rates of referral and participation have traditionally been low, especially among older adults.6,7

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Cardiac Rehabilitation Sessions Attended Among Patients 65 Years or Older After Acute Myocardial Infarction

This figure illustrates the percentage of referred and nonreferred patients 65 years or older who attended cardiac rehabilitation sessions after acute myocardial infarctions.

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