{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T04:23:46Z","timestamp":1764995026604,"version":"3.46.0"},"reference-count":35,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2015,10,14]]},"published-print":{"date-parts":[[2015,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We sought to describe temporal trends in the sociodemographic and clinical characteristics of participants referred to cardiac rehabilitation (CR), and its effect on programme participation and all-cause mortality over 14\u2005years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A large CR centre in Toronto, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Consecutive patients between 1996 and 2010.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Referrals received were deterministically linked to administrative data, to complement referral form abstraction. Out-of-hospital deaths were identified using vital statistics. Patients were tracked until 2012, and mortality was ascertained. Percentage attendance at prescribed sessions was also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 29\u2005171 referrals received, of which 28\u2005767 (98.6%) were successfully linked, of whom 22\u2005795 (79.2%) attended an intake assessment. The age of the referred population steadily increased, with more females, less affluent and more single patients referred over time (p&lt;0.001). More patients were referred following percutaneous coronary intervention and less following coronary artery bypass graft surgery (p&lt;0.001). The number of comorbidities decreased (p&lt;0.001). Hypertension increased over time (p&lt;0.001), yet the control of cholesterol steadily improved over time. The proportion of smokers decreased over time (p&lt;0.001). Participation in CR significantly declined, and there were no significant changes in mortality. 3-year mortality rates were less than 5%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Characteristics of referred patients tended to reflect broader trends in risk factors and cardiovascular disease burden. Physicians appear to be referring more sociodemographically diverse patients to CR; however, programmes may need to better adapt to engage these patients to fully participate. More complex patients should be referred, using explicit criteria-based referral processes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2015-009523","type":"journal-article","created":{"date-parts":[[2015,11,4]],"date-time":"2015-11-04T22:36:43Z","timestamp":1446676603000},"page":"e009523","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Observing temporal trends in cardiac rehabilitation from 1996 to 2010 in Ontario: characteristics of referred patients, programme participation and mortality rates"],"prefix":"10.1136","volume":"5","author":[{"given":"Sherry L","family":"Grace","sequence":"first","affiliation":[{"name":"School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada"},{"name":"Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institution, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul I","family":"Oh","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institution, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Marzolini","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institution, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracey","family":"Colella","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institution, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongyao","family":"Tan","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institution, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A","family":"Alter","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institution, University Health Network, Toronto, Ontario, Canada"},{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,11,4]]},"reference":[{"key":"2025120519262713000_5.11.e009523.1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081197"},{"key":"2025120519262713000_5.11.e009523.2","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.081629"},{"key":"2025120519262713000_5.11.e009523.3","doi-asserted-by":"crossref","unstructured":"Heran BS , Chen JM , Ebrahim S , et al . 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