Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Feb 8;3(1):e000369.
doi: 10.1136/openhrt-2015-000369. eCollection 2016.

Does the timing of cardiac rehabilitation impact fitness outcomes? An observational analysis

Jennifer Fell  1 , Veronica Dale  1 , Patrick Doherty  1
Affiliations

Does the timing of cardiac rehabilitation impact fitness outcomes? An observational analysis

Jennifer Fell et al. Open Heart. .

Abstract

Objectives: To ascertain the characteristics associated with delayed cardiac rehabilitation (CR) and determine if an association between CR timing and fitness outcomes exists in patients receiving routine care.

Methods: The study used data from the UK National Audit of Cardiac Rehabilitation, a data set which captures information on routine CR practice and patient outcomes. Data from 1 January 2012 to 8 September 2015 were included. Logistic regression models were used to explore the relationship between timing of CR and fitness-related outcomes as measured by patient-reported exercise level (150 min/week: yes/no), Dartmouth quality of life physical fitness scale and the incremental shuttle-walk test.

Results: Based on UK data current CR practice shows that programmes do not always adhere to recommendations on the start of prompt CR, that is, start CR within 28 days of referral (42 days for coronary artery bypass graft (CABG)). Wait time exceeded recommendations in postmyocardial infarction (post-MI), elective percutaneous coronary intervention (PCI), MI-PCI and post-CABG surgery patients. This was particularly pronounced in the medically managed post-MI group, median wait time 40 days. Furthermore, statistical analysis revealed that delayed CR significantly impacts fitness outcomes. For every 1-day increase in CR wait time, patients were 1% less likely to improve across all fitness-related measures (p<0.05).

Conclusions: With the potential for suboptimal patient outcome if starting CR is delayed, efforts should be made to identify and overcome barriers to timely CR provision.

Keywords: QUALITY OF CARE AND OUTCOMES.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Patient flow diagram. CR, cardiac rehabilitation.
Figure 2
Figure 2
Median wait times by patient group with recommended wait time reference lines. CABG, coronary artery bypass graft; MI, myocardial infarction; PCI, percutaneous coronary intervention.
See this image and copyright information in PMC

References

    1. World Health Organisation. Cardiovascular diseases factsheet 317. WHO, 2015.
    1. Centre for Economics and Business Research. The economic cost of cardiovascular disease from 2014–2020 in six European economies. London: CEBR, 2014.
    1. NICE. MI-secondary prevention guideline 172. UK: NICE, 2013.
    1. Heran BS, Chen JM, Ebrahim S et al. . Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2011;(7):CD001800. - PMC - PubMed
    1. Piepoli MF, Corrà U, Adamopoulos S et al. . Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a Policy Statement from the Cardiac Rehabilitation Section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology. Eur J Prev Cardiol 2014;21:664–81. 10.1177/2047487312449597 - DOI - PubMed

Publication types