Study highlights shortfalls in cardiac rehabilitation

A study of cardiac patients by University of Sydney researchers at Concord Hospital has highlighted a crucial gap in the delivery of care, with many at risk patients missing out on effective means of extending their chances of survival.

The Concord Hospital study, carried out by Julie Redfern, a PhD student working with Professor Ben Freedman from the University’s Faculty of Medicine, compared two groups of patients recently discharged after hospitalisation for an acute coronary syndrome (ACS): those who did not access cardiac rehabilitation and those about to commence standard cardiac rehabilitation.

The study, supported by a grant from the National Heart Foundation, concluded that the large group of patients who don’t access cardiac rehabilitation have a much more adverse risk profile, tending to have a higher cholesterol, be less physically active and more associated risk factors such as obesity, smoking and depression. They were also found to have less knowledge about their own risk factors.

Coronary heart disease (CHD) is a major cause of morbidity and mortality in Australia and is associated with significant cost to the health service. Guidelines recommend that all patients who have been hospitalised with an ACS participate in secondary prevention, incorporating risk factor management such as lifestyle change and medication.

Despite the fact that secondary prevention is an effective means of extending overall survival, participation rates in cardiac rehabilitation are low (10-30 per cent) because of transport difficulties, work and social commitments, lack of perceived need, and functional impairment.

‘It has been recognised that patients’ knowledge of risk factors is an essential basis for active participation in lifestyle changes, medical adherence and improved quality of life – which are all important factors for optimal secondary prevention,’ said Dr Freedman.

‘This study highlights a crucial gap in the delivery of care – the patients with the greatest need and poorest knowledge are not accessing formal secondary prevention,’ he said.

The study concludes that further research is needed to identify alternative models for secondary prevention that reach a much wider group of post ACS patients and provide long-term management of risk.

For further information contact Jake O'Shaughnessy on +61 2 9351 4312 or 0421 617 861 or