A UK survey of phase 1 cardiac rehabilitation for patients with acute coronary syndrome

ObjectivesThis study investigated phase 1 cardiac rehabilitation (P1CR) for patients admitted with acute coronary syndrome and is the first to investigate P1CR in the UK in depth. The aims were to investigate the UK and any national differences in the provision, staffing, content of P1CR, national guidelines achieved and any identified barriers.DesignA self-completion questionnaire was posted to the cardiac rehabilitation centres on the databases of the British Association for Cardiac Rehabilitation and the British Heart Foundation in the period of 2004–2005.ParticipantsTwo hundred and eighty hospitals in the UK were identified.Main instrumentA questionnaire designed by the authors.ResultsA total of 247 (88%) centres returned the questionnaire. Ninety-three percent of these centres (230) provided P1CR for acute coronary syndrome. There was 100% nurse, 63% (145/230) dietician, 59% (135/230) pharmacist and 49% (112/230) physiotherapy involvement but underutilisation of other members of the cardiac rehabilitation healthcare team. Risk stratification to determine future cardiac or exercise complications was not carried out in 27% (59/230) of the P1CR centres. Not all 17 cardiac risk education topics were discussed with patients. Fifty-five percent (126/230) provided P1CR mobilisation plans and 61% (140/230) provided P1CR walking plans. Although 100% identified and consulted national guidelines, many barriers to implementation were identified, with 58% (133/230) citing lack of staff and 31% (71/230) funding.ConclusionCertain areas of P1CR need to be addressed to enable equity of evidence-based service. The underachievement of many aspects of the P1CR guidelines is of concern. The current study has also shown the need for more research into P1CR.