Professor Susan Dawkes
President, British Association for Cardiovascular Prevention and Rehabilitation (BACPR)
The NHS Long Term Plan set out a challenging target to increase uptake to cardiac rehabilitation programmes to 85% by 2028. Increased awareness of the programmes is needed in order to achieve this.
Many people are unsure what cardiac rehabilitation involves or they think it is merely exercise classes and subsequently consider it ‘not for them’. More needs to be done to ensure there is understanding of the many components it features, including lifestyle risk factor management to lessen the chances of the heart disease worsening and support for psychological health.
Marketing of cardiac rehabilitation, therefore, needs to improve otherwise the uptake targets will never be achieved. World Heart Day is a time in the year when much publicity is given to cardiovascular related topics. It is therefore a helpful time to highlight the importance of participation in cardiac rehabilitation to ensure people get the support needed to have a longer and better quality of life.
Increased modes of delivery
The British Association for Cardiovascular Prevention and Rehabilitation (BACPR) indicates that patients should have their needs assessed and an individualised plan for cardiac rehabilitation should be developed and implemented.
Modes of delivery have changed following the impact of the COVID-19 pandemic. Many cardiac rehabilitation services, literally overnight, changed to home and web-based rehabilitation since group activity was not possible.
Although group based programmes was previously the most common mode of delivery, this has now changed to home based programmes including home based manuals, digital platforms and mobile apps which allows for personal choice. Not all services offer these and there was previously some reluctance to do so, however this has evolved considerably.
Cardiac rehabilitation needs to be marketed better to increase people’s understanding of what is involved.
Identifying patients that will benefit
Traditionally, cardiac rehabilitation services provide support for patients after heart attack, heart surgery (heart valve replacement and coronary artery bypass) and those who have had ‘balloon intervention’ (coronary angioplasty) to widen their heart arteries and relieve angina symptoms.
Other groups of patients may also benefit such as those with congenital heart disease and people, mainly women, who suffer spontaneous coronary artery dissection (a tear in the wall of the heart artery). These people are often younger (less than 50 years old) and so differ from the traditional group of patients who access rehabilitation.
Little is known of how effective cardiac rehabilitation is in helping them to live well for longer and so more research is needed. It is essential though commissioners recognise the need to include these other groups of patients and adequately fund cardiac rehabilitation services accordingly. These patients deserve the support that cardiac rehabilitation provides.
Increased awareness needed
Cardiac rehabilitation needs to be marketed better to increase people’s understanding of what is involved and to increase participation to improve patients’ lives. The way it is delivered though needs to be personalised and offer true patient choice. Cardiovascular prevention and rehabilitation programmes should be more inclusive of all patients who have cardiovascular disease.