Rehabilitation Support via Postcard (RSVP): A Randomised Controlled Trial of a Postcard to Promote Uptake of Cardiac Rehabilitation

Ben Britton; Maria Murphy; Anna K Jansson; Andrew Boyle; Mitch J Duncan; Clare E Collins; Amanda L Baker; Jane Kerr; Julie Rutherford; Kerry J Inder; Ronald C Plotnikoff

doi:10.1016/j.hlc.2023.05.008

Rehabilitation Support via Postcard (RSVP): A Randomised Controlled Trial of a Postcard to Promote Uptake of Cardiac Rehabilitation

Heart Lung Circ. 2023 Aug;32(8):1010-1016. doi: 10.1016/j.hlc.2023.05.008. Epub 2023 Jun 9.

Authors

Affiliations

¹ School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Hunter New England Health, Newcastle, NSW, Australia.
² Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW, Australia.
³ Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW, Australia; Active Living Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.
⁴ School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
⁵ School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW, Australia; Active Living Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.
⁶ School of Health Science, College of Health and Wellbeing, The University of Newcastle, Newcastle, NSW, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia.
⁷ Hunter New England Health, Newcastle, NSW, Australia.
⁸ School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia.
⁹ Centre for Active Living and Learning, University of Newcastle, Newcastle, NSW, Australia; Active Living Research Program, Hunter Medical Research Institute, Newcastle, NSW, Australia. Electronic address: ron.plotnikoff@newcastle.edu.au.

PMID: 37302865
DOI: 10.1016/j.hlc.2023.05.008

Abstract

Purpose: The aim was to increase cardiac rehabilitation (CR) uptake using a novel intervention, Rehabilitation Support Via Postcard (RSVP), among patients with acute myocardial infarction discharged from two major hospitals in Hunter New England Local Health District (HNELHD), New South Wales, Australia.

Methods: The RSVP trial was evaluated using a two-armed randomised controlled trial design. Participants (N=430) were recruited from the two main hospitals in HNELHD, and enrolled and randomised to either the intervention (n=216) or control (n=214) group over a six-month period. All participants received usual care; however, the intervention group received postcards promoting CR attendance between January and July 2020. The postcard was ostensibly written as an invitation from the patient's admitting medical officer to promote timely and early uptake of CR. The primary outcome was CR attendance at outpatient HNELHD CR services in the 30-days post-discharge.

Results: Fifty-four percent (54%) of participants who received RSVP attended CR, compared to 46% in the control group; however this difference was not statistically significant (odds ratio [OR]=1.4, 95% confidence interval [CI]=0.9-2.0, p=0.11). Exploratory post-hoc analysis among four sub-groups (i.e., Indigeneity, gender, age and rurality), found that the intervention significantly increased attendance in males (OR=1.6, 95%CI=1.0-2.6, p=0.03) but had no significant impact on attendance for other sub-groups.

Conclusions: While not statistically significant, postcards increased overall CR attendance by 8%. This strategy may be useful to increase attendance, particularly in men. Alternative strategies are necessary to increase CR uptake among women, Indigenous people, older people and people from regional and remote locations.

Keywords: Cardiac rehabilitation; Cardiac rehabilitation uptake; Randomised controlled trial.

Publication types

Randomized Controlled Trial

MeSH terms

Aftercare
Aged
Australia
Cardiac Rehabilitation*
Female
Humans
Male
Myocardial Infarction*
Patient Discharge