An estimated seven out of 10 eligible patients in the UK don't receive cardiac rehabilitation despite its confirmed benefits in preventing further ill health and death, reveals a review published ahead of print in the journal Heart.

Cardiac rehabilitation includes some or all of a mixture of lifestyle advice on reducing known risk factors for heart problems; exercise training; physical activity programmes; and counselling.

As part of an integrated treatment programme, it reduces the risk of death and further ill health and improves quality of life by slowing disease progression and reducing the severity of troubling symptoms.

Research shows that those aged 65 and older who undertake cardiac rehabilitation programmes have death rates up to a third of those who are not part of such programmes.

It is also very cost effective, coming in at around £500 per person, which compares favourably with the costs of hospital admission.

But programmes are frequently under-funded and too rigid, say the authors, with cardiac rehabilitation rarely seen as "an important component of contemporary comprehensive cardiac care."

When it is offered, it tends to be given only to patients who have had a heart attack. Yet is it suitable for those with various heart problems, including exertional angina, stable heart failure, congenital heart disease and those with pacemakers, among others, say the authors.

Doctors need to do more to endorse the benefits of cardiac rehabilitation, and automatic referral after an inpatient stay should become the norm rather than the exception, they recommend.

Cardiac rehabilitation programmes should also shift from being predominantly hospital based to community or home based programmes to enable more patients to take part, they suggest.

"Cardiac rehabilitation remains grossly underutilised despite its benefits," they conclude. "Improving access and equity of services is vital to [its] future, yet remains constrained by underfunded and inflexible programmes."

Source
Heart