Exploring Factors Influencing Healthcare Providers' Referral Decisions to Cardiac Rehabilitation Programs in Riyadh City: A Cross-Sectional Study.

Cardiac rehabilitation programs (CRPs) improve outcomes and reduce mortality among patients with cardiovascular disease; however, referral rates remain suboptimal. This cross-sectional study investigated factors influencing referral decisions to CRPs among healthcare providers in Riyadh City. A self-administered online questionnaire was distributed to physicians, nurses, and allied healthcare professionals working in hospitals and primary healthcare centers. A total of 166 participants completed the survey. Overall, approximately 40% of participants reported referring patients to CRPs, with nurses demonstrating the highest referral rate. Referral likelihood was significantly associated with years of professional experience, with the highest referral rates observed among participants with 5-10 years of experience (p = 0.04). The most commonly reported barriers to referral included limited availability of cardiac rehabilitation centers, patient refusal, limited patient mobility, and shortages of trained or experienced staff. Patient comorbidities and lack of awareness regarding CRP benefits were also identified as important barriers. Regarding CRP delivery models, most participants preferred hospital-based programs, although many also considered home-based cardiac rehabilitation to be a practical and convenient alternative. These findings highlight the need for strategies aimed at improving CRP accessibility and strengthening referral practices in Saudi Arabia. Expanding rehabilitation services, improving healthcare provider training and awareness, and integrating structured referral pathways into healthcare systems may help increase referral rates and patient participation in CRPs. Further studies using larger and more representative samples are recommended to better evaluate referral practices and identify effective interventions for improving CRP utilization.