Healthcare providers should refer heart patients to cardiac rehabilitation to help reduce the risk of death and improve quality of life, say researchers from the Canadian Association of Cardiac Rehabilitation (CACR) and Canadian Cardiovascular Society (CCS).
Participating in cardiac rehabilitation after a cardiac illness, such as a heart attack, can reduce a patient's risk of death by approximately 25%. This risk reduction is similar to that of other standard therapies, such as cholesterol-lowering medications (statins) and aspirin. In spite of this evidence, only 20-30% of patients are referred to a cardiac rehabilitation program after hospital discharge.
The joint policy position, Systematizing Inpatient Referral to Cardiac Rehabilitation, was published in the Canadian Journal of Cardiology and the Journal of Cardiopulmonary Rehabilitation & Prevention.
CACR and CCS researchers reviewed evidence on multiple strategies to increase referrals to cardiac rehabilitation. These included: a discharge checklist for doctors; electronic referral in medical records; bedside-discussions with patients; and even a motivational letter for patients.
The researchers recommend a combined approach -- a checklist or electronic referral and talking with patients.
"Every patient discharged from the hospital with a heart condition should be referred to a cardiac rehab program," says Dr. Sherry Grace, who chaired the Position Statement Committee.
"Our rigorous review of the evidence shows we have the tools to ensure 70% of these referred patients enroll. So this is now our national target," says Dr. Grace.
Cardiac rehabilitation offers a comprehensive approach to health by combining medical treatments and lifestyle modification. Patients benefit from a variety of services, including: education sessions; nutritional assessment with a dietitian; risk factor treatment (hypertension, cholesterol and smoking cessation) by physicians and nurses; medication review with a pharmacist; targeted exercise prescribed by an exercise physiologist; and supervised exercise by kinesiologists.
Dr. Bob Reid, President of the CACR and Associate Director of the Minto Prevention and Rehabilitation Centre of the University of Ottawa Heart Institute, calls for immediate action to address the low use of cardiac rehabilitation in Canada by using proven referral strategies to increase patient enrollment.
"We look forward to implementing the recommendations in this policy position," says Dr. Reid, "A national review of the need, supply and financing of cardiac rehab in Canada is necessary."
Source:
Canadian Association of Cardiac Rehabilitation