Psychologist's letter improves MI patient compliance with rehabilitation


LONDON (Reuters Health) – Significantly more patients attend cardiac rehabilitation classes following myocardial infarction when a psychologist write the appointment letter, a conference heard on Wednesday.

Only 59 percent of patients turned up after receiving standard appointment letters in a study at Gloucestershire Royal Hospital in western England. But this figure rose to 86 percent when the letters were specially designed to influence patient behaviour.

Sarah Wyer, clinical psychologist at the hospital, told a joint meeting of the British and European psychological societies in St Andrews, Scotland, that because some studies show only 21% of patients attend rehabilitation programmes, it was vital to boost attendance rates.

Her own study compared what happened to 87 participants who were randomly assigned either to the control group that received standard letters or to an experimental group that received letters written in accord with the theory of planned behaviour.

The letters sent to the experimental group stated that patients who attend rehabilitation are more likely to recover sooner and better than those who do not attend and pointed out that "attendance can reduce the chances of dying from another heart attack."

The letters also emphasised that patients have the power to influence their own destiny. "During this programme, you will be offered advice and information about the best ways to recover after a heart attack. This will help you to make informed choices enabling you to recover as well and as quickly as possible. Experience has shown that the more effort you can put in, the more quickly these results will be achieved. So, to a certain extent, how you recover will be up to you."

Results showed that 37 (86%) of the 43 patients in the experimental group attended rehabilitation compared with 26 (59%) of the 44 patients in the control group.

Wyer said that "by use of this simple cost-effective intervention…attendance was increased in an optimal way ensuring efficient use of resources."

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