Tag Archives: cardiac rehabilitation

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Introduction Coronary heart disease is a common killer and accounts for approximately 105,000 deaths per year in the UK. Recent research has shown that the most effective strategy, despite the advances in interventional cardiology, is effective secondary prevention and risk factor modification along with a robust rehabilitation programme to improve lifestyle, especially for those who have experienced a coronary event.2 It is also the most cost-effective way of reducing cardiovascular mortality and morbidity. Salvaging the acutely ischaemic myocardium with catheter-based interventions without addressing the underlying pathophysiological proces

Creative solutions Andrew Kenworthy, the chief executive for NHS Nottingham City Primary Care Trust, and an adviser to the PCCS, set the scene for the meeting with his keynote speech on World Class Commissioning. He told delegates that although times were going to be hard in the next few years, he hoped that such financial adversity would lead to creative solutions. In the session that followed, ‘How can we make change happen’, panelist Dr Adrian Brown, a consultant in public health medicine at NHS Westminster, told of two innovative programmes which, along with NHS Health Checks, were helping to transform his area. Westminster has major

A reminder The article by Pollard and Sutherland (pages 247–49) reminds us of the importance of such effective treatments as smoking cessation, regular exercise, a balanced diet enriched by fresh fruit but deficient in trans-fats, and a suitable body mass index.2 The author presents findings from a survey conducted on patients offered CR in the light of Department of Health guidelines outlined in the National Service Framework (NSF) for Coronary Heart Disease (2000), and raises several points.3 First, CR has once again been shown to achieve its intended goals. Additionally, it is an extremely popular intervention among patients, with nearly

Introduction Cardiac rehabilitation aims to address all modifiable behavioural risk factors that are susceptible to intervention, including smoking, exercise, diet and weight.1,2 Since less than half of eligible patients attended the out-patient-based cardiac rehabilitation programme at St George’s Hospital, we wanted to establish whether our service was beneficial and popular with patients, and what features might persuade others to participate. This evidence would enable us to improve our service and increase attendance, thereby reducing the risk of further cardiac events, with consequent benefits to patients, their families and healthcar

Introduction Figure 1. The five stages of the transtheoretical model (adapted from ref. 8) Exercise-based cardiac rehabilitation (CR) is embedded in cardiac care and can reduce cardiovascular mortality by 30% and death from all causes by 20–25%.1,2 Phase III CR is the stage of the patient journey in the UK that is primarily delivered in a hospital setting.3 It is acknowledged that strategies to increase adherence and participation are needed to maximise health gains from participation in CR.3 Predicting uptake and adherence has, to date, focused on traditional measures, e.g. age.3 New aspects are receiving some attention, these include disp

Numerous studies have demonstrated and explored the complex factors associated with low attendance at cardiac rehabilitation. Non-participants tend to be older, female, and more socially deprived, and to live further from the rehabilitation centre.11-13 Organisational factors comprise part of the reason for this. Unsurprisingly, access problems, including long travelling distances, poor public transport and poor parking facilities, discourage participation.14 Women and older people may be less likely to be invited or encouraged to take part. The task of organising programmes, to ensure that everyone eligible is invited and places are availabl

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Introduction Risk stratification is important in the assessment of cardiac patients enrolled in physical training programmes to ensure that these patients receive the appropriate levels of surveillance and exercise intensity. Risk levels, an estimate of the likelihood of future cardiac events, are indicated as low, moderate or high. Poor left ventricular (LV) function is the most important risk factor for death.1,2 The gold standard for assessing LV function is echocardiography but this is expensive and is often not available to cardiac rehabilitation co-ordinators. The additional information provided by plasma B-type natriuretic peptide (BNP

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