December 2013 Br J Cardiol 2013;20(suppl 3):S1–S19 doi:10.5837/bjc.2013.s04
Kornelia Kotseva, Elizabeth L Turner, Catriona Jennings, David A Wood, on behalf of ASPIRE-2-PREVENT Study Group
The main objective of cardiovascular prevention and rehabilitation in clinical practice is to reduce the risk of future vascular events, to improve quality of life and increase life expectancy. Cardiac rehabilitation (CR) is recommended by the British Association for Cardiovascular Prevention and Rehabilitation (BACPR).1 This second edition of the Standards and Core Components (SCC) for Cardiovascular Disease Prevention and Rehabilitation from the BACPR, define CR through seven standards and seven core components for assuring a quality service of care using a multi-disciplinary biological and psychosocial approach.2 However, the implementatio
February 2011 Br J Cardiol 2011;18:s13-s5
Julian Halcox - Professor of Cardiology and Consultant Cardiologist
To address the question of increasing engagement with CR programmes in target areas, in 2009, I chaired a Steering Committee convened by Abbott Healthcare Products Ltd. (formerly Solvay Healthcare) called ‘Setting the Standard for Cardiac Rehabilitation’ (START). The Steering Committee advised that the existing Cardiac Networks in each region would be the best forum for disseminating information about changes in CR funding and standards of care in this field. Abbott Healthcare Products Ltd. kindly agreed to organise a series of meetings in the UK, held during 2009 and early 2010, with the aim of raising awareness of the importance of CR a
February 2011 Br J Cardiol 2011;18:s13-s5
John Buckley
WHO definition The World Health Organization (WHO) defined CR in 1993 in a timeless way that is inclusive and sensitive to the psychosocial, biomedical, professional expertise and service delivery mode and location elements required of a contemporary CR service. “The sum of activities required to influence favourably the underlying cause of the disease so that (people) may by their own efforts preserve, or resume when lost, as normal a place in the community… …it must be integrated within secondary prevention services of which it forms one facet”.3 BACR definition This article reflects on how this definition dovetails with the BACR St
February 2011 Br J Cardiol 2011;18:s13-s5
Dr E Jane Flint
In fact, fewer than half of networks have ever benefited from Patient Choice Revascularisation Pathway monies, which were originally intended to support CR also.2 The START meeting in Birmingham in December 2009 was an opportunity to celebrate the innovative approach undertaken by the West Midlands’ Regional NSF Implementation Group for Cardiac Rehabilitation and Secondary Prevention, describing local CR pathway service standards against which West Midlands’ CR programmes could be audited to inform commissioning. The subsequent proportional allocation of ‘Patient Choice’ rehabilitation funding across Birmingham and the Black Country w
February 2011 Br J Cardiol 2011;18:s8-s10
Judith Edwards
The service at Charing Cross was used as the model for EUROACTION, a randomised, controlled trial of a preventive cardiology programme, conducted in eight European countries, including the UK. This nurse-led multidisciplinary programme significantly improved the management of lifestyle and medical risk factors for cardiovascular disease prevention in coronary patients and patients at high multifactorial risk for developing heart disease.1 The principles of the EUROACTION programme were used to found The MyAction community programme, commissioned in 2008 by NHS Westminster as a model for preventive cardiology care for its residents. The Imperi
February 2011 Br J Cardiol 2011;18:s11-s2
John Buckley
What is beneficial exercise? A prime question needs to be considered before furthering this discussion: what is meant by beneficial exercise? The benefits of exercise impact on all aspects of health – physiological, psychological and social. A study by Fox (1999) found that short bouts of any activity, even low-intensity activity that may not bring about a significant physiological risk factor change, if it is performed regularly, will provide psychological benefits to self-esteem and self-efficacy, and reductions in anxiety and depression.2 Angina patients engaging in regular walking on a similar premise to that expressed by Fox show signi
February 2011 Br J Cardiol 2011;18:s13-s5
Amarjit Sethi, John Townend, Adrian Brady, Julian Halcox
North West London To try and identify local barriers and share good practice, we have been regularly reviewing our cardiac rehabilitation (CR) services in North West London. Through this process we hope to increase the average uptake in a step-wise fashion from 50–60% to the national target of 85%.1 Lack of appropriately funded services and low staffing levels are real problems across the sector, unfortunately. Nevertheless, some innovative approaches to CR are taking place. The uptake of CR services after primary percutaneous coronary intervention (PPCI) for myocardial infarction has increased from 26% to 84% at Imperial College Healthcare
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