Year of Award


Document Type

Professional Paper

Degree Type

Master of Science (MS)

Degree Name

Health and Human Performance (Exercise Science Option)

Department or School/College

Department of Health and Human Performance

Committee Chair

Steve Gaskill

Commitee Members

Ryan Mays, Stephanie Domitrovich


cardiac rehabilitation, referral strategies, enrollment rates


University of Montana


Cardiovascular disease is the leading cause of hospitalizations and deaths in the United States. Although cardiac rehabilitation is recognized as a standard element of continuum of cardiac care only 10-60% of eligible patients participate. Various barriers exist preventing cardiac patients to enroll in cardiac rehabilitation. These barriers are categorized into three different levels: 1) patient barriers, 2) physician barriers and 3) healthcare system barriers. Patient barriers can include lack of insurance, transportation, need to return to work, family issues and the perception cardiac rehabilitation is not needed but lack of physician referral is the leading deterrent for patients not enrolling in cardiac rehabilitation. Numerous reasons have been found to influence whether or not a physician processes a referral including age and gender of the patient, motivation of patient, type of physician (primary care versus cardiologist) and lack of knowledge on local cardiac rehabilitation facilities. One way researchers have found to overcome the obstacles related to issuing a referral is for the hospital and staff to utilize an automatic referral system along with trained liaisons to increase the enrollment rates of cardiac rehabilitation. While this strategy has proven to be effective in increasing referral and enrollment rates there is still a need for strategies that address other barriers for cardiac patients. Home-based cardiac rehabilitation programs can address the problems of transportation, family and work-related issues and the preference of not exercising in group settings. Home-based programs give the patients more freedom and therefore can help increase exercise adherence rates.



© Copyright 2014 Whitney Tameler