Cardiac rehabilitation: Adding years to life and life to years

Thompson, David (2009) Cardiac rehabilitation: Adding years to life and life to years. Journal of Research in Nursing, 14 3: 207-219. doi:10.1177/1744987109102733

Author Thompson, David
Title Cardiac rehabilitation: Adding years to life and life to years
Journal name Journal of Research in Nursing   Check publisher's open access policy
ISSN 1744-9871
Publication date 2009-05
Year available 2009
Sub-type Article (original research)
DOI 10.1177/1744987109102733
Volume 14
Issue 3
Start page 207
End page 219
Total pages 13
Editor Veronica Bishop
Place of publication London, United Kingdom
Publisher Sage Publications Ltd
Collection year 2010
Language eng
Subject C1
321003 Cardiology (incl. Cardiovascular Diseases)
920103 Cardiovascular System and Diseases
110201 Cardiology (incl. Cardiovascular Diseases)
Abstract Cardiac rehabilitation is an integral component of comprehensive cardiac care and is effective in reducing morbidity and mortality and improving quality of life. However, despite a 50-year-history and extensive evidence base attesting to its clinical and cost-effectiveness, including adding years to life and life to years, and exhortations that its implementation should be a key priority, the majority of cardiac patients do not receive rehabilitation. There is a comparative dearth of funding and wide variation in service provision, with a health care system that often fails to address issues such as sub-optimal referral, enrolment and completion, particularly amongst certain potential user groups that could benefit. This paper reviews these issues and suggests ways of overcoming the obstacles identified. It also highlights some of the knowledge gaps and areas that warrant further research.
Keyword cardiac rehabilitation
quality of life
References Ades, PA (2001) Cardiac rehabilitation and secondary prevention of coronary heart disease. New Engl J Med 345: 892–902. American Association of Cardiovascular and Pulmonary Rehabilitation (2004) Guidelines for Cardiac Rehabilitation and Secondary Prevention, Fourth ed. Champaign, IL: Human Kinetics. Arthur, HM, Patterson, C, Stone, JA (2006) The role of complementary and alternative therapies in cardiac rehabilitation: a systematic evaluation. Eur J Cardiovasc Prev Rehabil 13: 3–9. Arthur, HM, Smith, KM, Kodis, J, McKelvie, R (2002) A controlled trial of hospital versus home-based exercise in cardiac patients. Med Sci Sports Exerc 34: 1544–1550. Beswick, AD, Rees, K, Griebsch, I, Taylor, FC, Burke, M, West, RR, et al. (2004) Provision, uptake and cost of cardiac rehabilitation programmes: improving services to under-represented groups. Health Technol Assess 8: 1–152. Beswick, AD, Rees, K, West, RR, Taylor, FC, Burke, M, Griebsch, I, et al. (2005) Improving uptake and adherence in cardiac rehabilitation: literature review. J Adv Nurs 49: 538–555. Bethell, HJN, Evans, J, Turner, SC, Lewin, RJ (2006) The rise and fall of cardiac rehabilitation in the United Kingdom since 1998. J Public Health 29: 57–61. Bethell, HJN, Lewin, RJP, Dalal, HM (2008) Cardiac rehabilitation: it works so why isn’t it done? Br J Gen Pract 58: 677–679. Bobbio, M (1989) Does post myocardial infarction rehabilitation prolong survival? A meta-analytic survey. G Ital Cardiol 19: 1059–1067. Bowman, GS, Bryar, RM, Thompson, DR (1998a) Is the place for cardiac rehabilitation in the community? Soc Sci Health 4: 261–272. Bowman, GS, Thompson, DR, Lewin, RJP (1998b) Why are patients with heart failure not routinely offered cardiac rehabilitation? Coronary Health Care 2: 187–192. Briffa, TG, Eckermann, SD, Griffiths, AD, Harris, PJ, Heath, MR, Freedman, SB, et al. (2005) Cost-effectiveness of rehabilitation after an acute coronary event: a randomized controlled trial. Med J Aust 183: 450–455. British Association for Cardiac Rehabilitation (2007) Standards and Core Components for Cardiac Rehabilitation. London: BACR. Brodie, D, Bethell, H, Breen, S (2006) Cardiac rehabilitation in England: a detailed national survey. Eur J Cardiovasc Prev Rehabil 13: 122–128. Brubaker, PH (2005) Is home-based cardiac rehabilitation a preferred and viable option. J Cardiopulm Rehabil 25: 30–32. Canadian Association of Cardiac Rehabilitation (1999) Canadian Guidelines for Cardiac Rehabilitation and Cardiovascular Disease Prevention. Winnipeg: CACR. Clark, AM, Barbour, RS, McIntyre, PD (2002) Preparing for change in the secondary prevention of coronary heart disease: a qualitative evaluation of cardiac rehabilitation within a region of Scotland. J Adv Nurs 39: 589–598. Clark, AM, Barbour, RS, White, M, McIntyre, PD (2004) Promoting participation in cardiac rehabilitation: patient choices and experiences. J Adv Nurs 47: 5–14. Clark, AM, Hartling, L, Vandermeer, B, Lissel, SL, McAlister, FA (2007a) Secondary prevention programmes for coronary heart disease: a metaregression showing the merits of shorter, generalist, primary-care based interventions. Eur J Cardiovasc Prev Rehabil 14: 538–546. Clark, AM, Hartling, L, Vandermeer, B, McAlister, FA (2005a) Randomized Trials of Secondary Prevention Programs for in Coronary Artery Disease: a Systematic Review. Rockville, MD: Agency for Healthcare Research and Quality. Clark, AM, Hartling, L, Vandermeer, B, McAlister, FA (2005b) Meta-analysis: secondary prevention programs for patients with coronary artery disease. Ann Intern Med 143: 659–672. Clark, AM, McIntyre, PD, Cruickshank, J (2007b) A critical realist approach to understanding and evaluating heart health programmes. Health 11: 513–539. Clark, AM, Thompson, DR (2008) The future of management programmes for heart failure. Lancet 372: 784–786. Coats, AJS, McGee, HM, Stokes, HC, Thompson, DR (1995) BACR Guidelines for Cardiac Rehabilitation. Oxford: Blackwell. Cooper, AF, Jackson, G, Weinman, J, Horne, R (2002) Factors associated with cardiac rehabilitation attendance: a systematic review of the literature. Clin Rehabil 16: 541–552. Cooper, AF, Jackson, G, Weinman, J, Horne, R (2005) A qualitative study investigating patients’ beliefs about cardiac rehabilitation. Clin Rehabil 19: 87–96. Cooper, AF, Weinman, J, Hankins, M, Jackson, G, Horne, R (2007) Assessing patients’ beliefs about cardiac rehabilitation as a basis for predicting attendance after acute myocardial infarction. Heart 93: 53–58. Dafoe, W, Arthur, H, Stokes, H, Morrin, L, Beaton, L ; Canadian Cardiovascular Society Access to Care Working Group on Cardiac Rehabilitation (2006) Universal access: but when? Treating the right patient at the right time: access to cardiac rehabilitation. Can J Cardiol 22: 1697–1975. Dalal, HM, Evans, PH (2003) Achieving national service framework standards for cardiac rehabilitation and secondary prevention. BMJ 326: 481–484. Dalal, HM, Evans, PH, Campbell, JL, Taylor, RS, Watt, A, Read, KL, et al. (2007) Home-based versus hospitalbased rehabilitation after myocardial infarction: a randomized trial with preference arms – Cornwall Heart Attack Rehabilitation Management Study (CHARMS). Int J Cardiol 119: 202–211. Daly, J, Sindone, AP, Thompson, DR, Hancock, K, Chang, E, Davidson, P (2002) Barriers to participation in and adherence to cardiac rehabilitation programs: a critical literature review. Prog Cardiovasc Nurs 17: 8–17. Department of Health (2000) National Service Framework for Coronary Heart Disease. London: Department of Health. Department of Health (2005) Coronary Heart Disease National Service Framework: Leading the Way – Progress Report 2005. London: Department of Health. Dinnes, J, Kleijnen, J, Leitner, M, Thompson, DR (1999) Cardiac rehabilitation. Qual Health Care 8: 65–71. Dollard, J, Smith, J, Thompson, DR, Stewart, S (2004) Broadening the reach of cardiac rehabilitation to remote and rural Australia. Eur J Cardiovasc Nurs 3: 27–42. Dusseldorp, E, van Elderen, T, Maes, S, Meulman, J, Kraajj, V (1999) A meta-analysis of psychoeducational programs for coronary heart disease patients. Health Psychol 18: 506–519. Fischer, JP (2008) Automatic referral to cardiac rehabilitation. J Cardiovasc Nurs 23: 474–479. French, DP, Cooper, A, Weinman, J (2006) Illness perceptions predict attendance at cardiac rehabilitation following acute myocardial infarction: a systematic review with meta-analysis. J Psychosom Res 61: 757–767. French, DP, Lewin, RJP, Watson, N, Thompson, DR (2005) Do illness perceptions predict attendance at cardiac rehabilitation and quality of life following myocardial infarction? J Psychosom Res 59: 315–322. Grace, SL, Gravely-Witte, S, Brual, J, Monette, G, Suskin, N, Higginson, L, et al. (2008a) Contribution of patient and physician factors to cardiac rehabilitation enrollment: a prospective multilevel study. Eur J Cardiovasc Prev Rehabil 15: 548–556. Grace, SL, Gravely-Witte, S, Brual, J, Suskin, N, Higginson, L, Alter,D, et al. (2008b) Contribution of patient and physician factors to cardiac rehabilitation referral: a prospective multilevel study. Nat Clin Pract Cardiovasc Med 5: 653–662. Grace, SL, Grewal, K, Stewart, DE (2008c) Factors affecting cardiac rehabilitation referral by physician activity. J Cardiopulm Rehabil Prev 28: 248–252. Grace, SL, Krepostman, S, Brooks, D, Jaglal, S, Abramson, BL, Scholey, P, et al. (2006) Referral to and discharge from cardiac rehabilitation: key informant views on continuity of care. J Eval Clin Pract 12: 155–163. Grace, SL, McDonald, J, Fishman, D, Caruso, V (2005) Patient preferences for home-based versus hospital-based cardiac rehabilitation. J Cardiopulm Rehabil 25: 24–29. Gray, A, Bowman, GS, Thompson, DR (1997) The cost of cardiac rehabilitation services in England and Wales. J R Coll Physicians Lond 31: 57–61. Hancock, H, Davidson, PM, Daly, J, Webber, D, Chang, E (2005) An exploration of the usefulness of motivational interviewing in facilitating secondary prevention gains in cardiac rehabilitation. J Cardiopulm Rehabil 25: 200–206. Harris, DE, Record, NB (2003) Cardiac rehabilitation in community settings. J Cardiopulm Rehabil 23: 250–259. Healthcare Commission (2005) Getting to the Heart of it. Coronary Heart Disease in England: a Review of Progress Towards the National Standards. London: Healthcare Commission. Jackson, L, Leclerc, J, Erskine, Y, Linden, W (2005) Getting the most out of cardiac rehabilitation: a review of referral and adherence predictors. Heart 91: 10–14. Jolliffe, JA, Rees, K, Taylor, RS, Thompson, D, Oldride, N, Ebrahim, S (2001) Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev (1): CD001800. Jolly, K, Taylor, RS, Lip, GY, Stevens, A (2006) Homebased cardiac rehabilitation compared with centre-based rehabilitation and usual care: a systematic review and meta-analysis. Int J Cardiol 111: 343–351. Jones, M, Jolly, K, Raftery, J, Lip, GY, Greenfield, S, BRUM Steering Committee (2007) ‘DNA’ may not mean ‘did not participate’: a qualitative study of reasons for nonadherence at home- and centre-based cardiac rehabilitation. Fam Pract 24: 343–357. Lacey, EA, Musgrave, RJ, Freeman, JV, Tod, AM, Scott, P (2004) Psychological morbidity after myocardial infarction in an area of deprivation in the UK: evaluation of a self-help package. Eur J Cardiovasc Nurs 3: 219–224. Lau-Walker, M (2004) Cardiac rehabilitation: the importance of patient expectations – a practitioner survey. J Clin Nurs 13: 177–184. Lau-Walker, M (2006) A conceptual care model for individualized care approach in cardiac rehabilitation – combining both illness representation and self-efficacy. Br J Health Psychol 11: 103–107. Leon, AS, Franklin, BA, Costa, F, Balady, GJ, Berra, KA, Stewart, KJ, et al., American Heart Association Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention); Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), American Association of Cardiovascular and Pulmonary Rehabilitation (2005) Cardiac rehabilitation and secondary prevention of coronary heart disease. Circulation 111: 369–376. Lewin, B, Robertson, IH, Cay, EL, Irving, JB, Campbell, M (1992) Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services. Lancet 339: 1036–1040. Lewin, RJP, Ingleton, R, Newens, A, Thompson, DR (1998) Adherence to cardiac rehabilitation guidelines: a survey of rehabilitation programmes in the United Kingdom. BMJ 316: 1354–1355. Lewin, RJP, Thompson, DR, Roebuck, A (2004) Development of the BACR/BHF minimum dataset for cardiac rehabilitation. Br J Cardiol 11: 300–301. Linden, W, Phillips, MJ, Leclerc, J (2007) Psychological treatment of cardiac patients: a meta-analysis. Eur Heart J 28: 2972–2984. Linden, W, Stossel, C, Maurice, J (1996) Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch Intern Med 156: 745–752. Mayou, RA, Thompson, DR, Clements, A, Davies, CH, Goodwin, SJ, Normington, K, et al. (2002) Guidelinebased early rehabilitation after myocardial infarction: a pragmatic randomised controlled trial. J Psychosom Res 52: 89–95. Mayou, RA, Welstand, J, Tyndel, S (2005) Setting up and auditing guideline- and evidence-based cardiac rehabilitation. Eur J Cardiovasc Nurs 4: 23–28. Molloy, GJ, Hamer, M, Randall, G, Chida, Y (2008) Marital status and cardiac rehabilitation attendance: a meta-analysis. Eur J Cardiovasc Prev Rehabil 15: 557–561. National Institute for Health and Clinical Excellence (2007) Clinical Guideline 48. Secondary Prevention in Primary and Secondary Care for Patients Following a Myocardial Infarction. London: NICE. O’Connor, GT, Buring, JE, Yusuf, S, Goldhaber, SZ, Olmstead, EM, Paffenbarger Jr, RS, et al. (1989) An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation 80: 234–244. O’Driscoll, JM, Shave, R, Cushion, CJ (2007) A National Health Service hospital’s cardiac rehabilitation programme: a qualitative analysis of provision. J Clin Nurs 16: 1908–1918. Oldridge, N, Guyatt, G, Fischer, M, Rimm, A (1988) Cardiac rehabilitation after myocardial infarction. Combined experience of randomized clinical trials. JAMA 260: 945–950. Oldridge, N, Furlong, W, Perkins, A, Feeny, D, Torrance,GW (2008) Community or patient preferences for costeffectiveness of cardiac rehabilitation: does it matter? Eur J Cardiovasc Prev Rehabil 15: 608–615. Papadakis, S, Oldridge, NB, Coyle, D, Mayhew, A, Reid, RD, Beaton, L, et al. (2005) Economic evaluation of cardiac rehabilitation: a systematic review. Eur J Cardiovasc Prev Rehabil 12: 513–520. Papadakis, S, Read, RD, Coyle, D, Beaton, L, Angus, D, Oldridge, N (2008) Cost-effectiveness of cardiac rehabilitation program delivery models in patients at varying cardiac risk, reason for referral, and sex. Eur J Cardiovasc Prev Rehabil 15: 347–353. Rees, K, Victory, J, Beswick, AD, Turner, SC, Griebsch, I, Taylor, FC, et al. (2005) Cardiac rehabilitation in the UK; uptake among under-represented groups. Heart 91: 375–376. Reid, RD, Dafoe, WA, Morrin, L, Mayhew, A, Papadakis, S, Beaton, L, et al. (2005) Impact of program duration and contact frequency on efficacy and cost of cardiac rehabilitation: results of a randomized trial. Am Heart J 149: 862–868. Riley, DL, Stewart, DE, Grace, SL (2007) Continuity of cardiac care: cardiac rehabilitation participation and other correlates. Int J Cardiol 119: 326–333. Sanderson, BK, Southard, D, Oldridge, N (2004) AACVPR consensus statement. Outcomes evaluation in cardiac rehabilitation/secondary prevention programs. J Cardiopulm Rehabil 24: 68–79. Scott, JT, Thompson, DR (2003) Assessing the information needs of post-myocardial infarction patients: a systematic review. Patient Educ Couns 50: 167–177. Scottish Intercollegiate Guidelines Network (2002) Cardiac Rehabilitation. A National Clinical Guideline. Edinburgh: Royal College of Physicians. Smith, KM, Arthur, HM, McKelvie, RS, Kodis, J (2004) Differences in sustainability of exercise and healthrelated quality of life outcomes following home or hospital-based cardiac rehabilitation. Eur J Cardiovasc Prev Rehabil 11: 313–319. Taylor, RS, Brown, A, Ebrahim, S, Jolliffe, J, Noorani, H, Rees, K, et al. (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 116: 682–692. Taylor, RS, Watt, A, Dalal, HM, Evans, PH, Campbell, JL, Read, KL, et al. (2007) Home-based cardiac rehabilitation versus hospital-based rehabilitation: a cost effectiveness analysis. Int J Cardiol 119: 196–201. Thomas, RJ, King, M, Lui, K, Oldridge, N, Pina, IL, Spertus, J, et al. (2007) AACVPR /ACC /AHA 2007 performance measures on cardiac rehabilitation for referral to and delivery of cardiac rehabilitation/ secondary prevention services. Circulation 116: 1611– 1642. Thompson, DR (1994) Cardiac rehabilitation services: the need to develop guidelines. Qual Health Care 3: 169–172. Thompson, DR (1995) Cardiac rehabilitation: how can it be improved? J Psychosom Res 39: 519–523. Thompson, DR (1998) The development of a programme of research in cardiac rehabilitation. Int J Nurs Stud 35: 72–78. Thompson, DR (2002) Involvement of the partner in rehabilitation. In: Jobin, J, Maltais, F, Poirier, P, LeBlanc, P, Simard, C (eds), Advancing the Frontiers of Cardiopulmonary Rehabilitation. Champaign, IL: Human Kinetics, pp. 211–215. Thompson, DR (2007) Improving the end-of-life care for patients with chronic heart failure. Heart 93: 901–902. Thompson, DR, Bowman, GS, de Bono, DP, Hopkins, A (1997a) The development and testing of a cardiac rehabilitation audit tool. J R Coll Physicians Lond 31: 317–320. Thompson, DR, Bowman, GS, De Bono, DP, Hopkins, A (1997b) Cardiac Rehabilitation: Guidelines and Audit Standards. London: Royal College of Physicians. Thompson, DR, Bowman, GS, Kitson, AL, de Bono, DP, Hopkins, A (1996) Cardiac rehabilitation in the United Kingdom: guidelines and audit standards. Heart 75: 89–93. Thompson, DR, Bowman, GS, Kitson, AL, de Bono, DP, Hopkins, A (1997) Cardiac rehabilitation services in England and Wales: a national survey. Int J Cardiol 59: 299–304. Thompson, DR, Cordle, CJ (1988) Support of wives of myocardial infarction patients. J Adv Nurs 13: 223–228. Thompson, DR, Ersser, S, Webster, RA (1995) The experiences of patients and their partners one month after a heart attack. J Adv Nurs 22: 707–714. Thompson, DR, Lewin, RJP (2000) Management of the post-myocardial infarction patient: rehabilitation and cardiac neurosis. Heart 84: 101–105. Thompson, DR, Meddis, R (1990a) Wives’ responses to counselling early after myocardial infarction. J Psychosom Res 34: 249–258. Thompson, DR, Meddis, R (1990b) A prospective evaluation of in-hospital counselling for first-time myocardial infarction men. J Psychosom Res 34: 237–248. Thompson, DR, Oldridge, N (2004) Secondary prevention and cardiac rehabilitation: have we got the terms right? Eur J Cardiovasc Prev Rehabil 11: 183–184. Thompson, DR, Stewart, S (2008) Chronic cardiovascular disease management: how can it be improved? Eur J Cardiovasc Prev Rehabil 15: 1–2. Thompson, PD, Franklin, BA (2004) From case report to meta-analysis – additional evidence for the benefits of exercise training in cardiac patients. Am J Med 116: 714–716. Tod, AM, Lacey, EA, McNeill, F (2002) ‘I’m still waiting…’: barriers to accessing cardiac rehabilitation services. J Adv Nurs 40: 421–431. Vanhees, L, McGee, HM, Dugmore, LD, Schepers, D, van Daele, P, Carinex Working Group: CArdiac Rehabilitation INformation EXchange (2002) A representative study of cardiac rehabilitation activities in European Union Member States: the Carinex survey. J Cardiopulm Rehabil 22: 264–272. Webster, RA, Thompson, DR, Davidson, P (2003) The first 12 weeks following discharge from hospital: the experience of Gujarati south Asian survivors of myocardial infarction and their families. Contemp Nurse 15: 288–299. Webster, RA, Thompson, DR, Mayou, RA (2002) The experiences and needs of Gujarati Hindu patients and partners in the first month after acute myocardial infarction. Eur J Cardiovasc Nurs 1: 69–76. Wenger, NK, Froelicher, ES, Smith, LK, Ades, PA, Berra, K, Blumenthal, JA, et al. (1995) Cardiac rehabilitation. Clinical practice guideline number 17. US Department of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute: Rockville, MD. Wood, DA, Kotseva, K, Connolly, S, Jennings, C, Mead, A, Jones, J, et al.; on behalf of EUROACTION Study Group (2008) Nurse-coordinated multidisciplinary, familybased cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster- randomised controlled trial. Lancet 371: 1999–2012. World Health Organization (1993) Needs and action priorities in cardiac rehabilitation and secondary prevention in patients with CHD. Copenhagen: WHO Regional Office for Europe.
Q-Index Code C1
Q-Index Status Confirmed Code

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Nursing, Midwifery and Social Work Publications
Version Filter Type
Citation counts: Scopus Citation Count Cited 8 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Wed, 06 May 2009, 14:31:42 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work