Abstract
Objective
to give a comprehensive description of the practice of outpatient cardiac rehabilitation in Scotland.
Design
an identifying survey of 1,270 individuals in hospital, general practice and community sources nationally, followed by computer-assisted telephone interviews about programme characteristics with key personnel from identified cardiac rehabilitation schemes.
Outcome measures
patient provision, referral criteria and programme features.
Results
65 programmes provided outpatient cardiac rehabilitation for 4,980 patients in one year, representing 17% of the 29,180 patients who survived admission to hospital with coronary heart disease. Cardiac rehabilitation practice varied widely: 53 (82%) programmes included exercise, although only 19 (29%) at the most beneficial level; 40 (62%) included relaxation training, although only three (5%) at a level shown to give benefit; 47 (72%) included education, although only 16 (25%) in a manner with reported benefits in randomised trials.
Conclusions
outpatient cardiac rehabilitation was provided to a minority of patients with coronary heart disease. Programmes varied widely, and were often more limited than those reporting mortality and morbidity benefits in randomised trials. There is a substantial gap between current provision and practice of cardiac rehabilitation and that advocated in published guidelines.
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Contributor Information
Neil C Campbell, Clinical Research Fellow, Department of General Practice, University of Aberdeen.
Jeremy M Grimshaw, Senior Lecturer, Department of General Practice, University of Aberdeen.
Lewis D Ritchie, Mackenzie Professor of General Practice, University of Aberdeen.
John M Rawles, Honorary Senior Lecturer, Medicines Assessment Research Unit, University of Aberdeen.