Why do so few patients with heart failure participate in cardiac rehabilitation? A cross-sectional survey from England, Wales and Northern Ireland
Open Access
- 26 March 2012
- Vol. 2 (2), e000787
- https://doi.org/10.1136/bmjopen-2011-000787
Abstract
Objectives To determine why so few patients with chronic heart failure in England, Wales and Northern Ireland take part in cardiac rehabilitation. Design Two-stage, postal questionnaire-based national survey. Participants and setting Stage 1: 277 cardiac rehabilitation centres that provided phase 3 cardiac rehabilitation in England, Wales and Northern Ireland registered on the National Audit of Cardiac Rehabilitation register. Stage 2: 35 centres that indicated in stage 1 that they provide a separate cardiac rehabilitation programme for patients with heart failure. Results Full data were available for 224/277 (81%) cardiac rehabilitation centres. Only 90/224 (40%) routinely offered phase 3 cardiac rehabilitation to patients with heart failure. Of these 90 centres that offered rehabilitation, 43% did so only when heart failure was secondary to myocardial infarction or revascularisation. Less than half (39%) had a specific rehabilitation programme for heart failure. Of those 134 centres not providing for patients with heart failure, 84% considered a lack of resources and 55% exclusion from commissioning contracts as the reason for not recruiting patients with heart failure. Overall, only 35/224 (16%) centres provided a separate rehabilitation programme for people with heart failure. Conclusions Patients with heart failure as a primary diagnosis are excluded from most cardiac rehabilitation programmes in England, Wales and Northern Ireland. A lack of resources and direct exclusion from local commissioning agreements are the main barriers for not offering rehabilitation to patients with heart failure.This publication has 31 references indexed in Scilit:
- Epidemiology and clinical course of heart failure with preserved ejection fractionEuropean Journal of Heart Failure, 2011
- Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory SurveyEuropean Journal of Preventive Cardiology, 2010
- Exercise training for systolic heart failure: Cochrane systematic review and meta‐analysisEuropean Journal of Heart Failure, 2010
- 2009 Focused Update Incorporated Into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in AdultsCirculation, 2009
- A randomized trial of the addition of home‐based exercise to specialist heart failure nurse care: the Birmingham Rehabilitation Uptake Maximisation study for patients with Congestive Heart Failure (BRUM‐CHF) studyEuropean Journal of Heart Failure, 2009
- ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM)European Heart Journal, 2008
- Long-term costs and resource use in elderly participants with congestive heart failure in the Cardiovascular Health StudyAmerican Heart Journal, 2007
- A new direction for NHS community servicesBMJ, 2006
- Achieving national service framework standards for cardiac rehabilitation and secondary preventionBMJ, 2003
- Cardiac rehabilitation: the agenda set by post-myocardial-infarction patientsHealth Education Journal, 1994