An analysis of barriers to entry of cardiac rehabilitation in patients with diabetes: Using data from the National Audit of Cardiac Rehabilitation

Harrison, Alexander; Doherty, Patrick; Phillips, Anne

doi:10.1177/1479164117744490

Cited by 16 publications

(15 citation statements)

References 13 publications

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“…Reported attendance rates in Australia vary considerably but range from 20% to 40% (Clark et al, ; Jelinek, Thompson, Ski, Bunker, & Vale, ; Redfern, Ellis, Briffa, & Freedman, ; Wachtel, ), while completion rates range from 31% to 56% (Tavella et al, ; SA Minimum database 2017). These figures are similar to those reported in the UK (Harrison, Doherty, & Phillips, ) and the US (Pack et al, ). One of the commonly cited barriers to CR attendance and completion is poor referral (National Heart Foundation NHF, ).…”

Section: Introductionsupporting

confidence: 90%

Exploration of a nurse practitioner‐led phase two cardiac rehabilitation programme on attendance and compliance

O’Toole¹,

Chamberlain

Giles

2019

Journal of Clinical Nursing

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Aims and Objectives To evaluate the impact of a nurse practitioner‐led phase two cardiac rehabilitation and secondary prevention programme on attendance and compliance. Background Despite strong evidence for the benefits of cardiac rehabilitation, attendance/completion rates remain low. Nurse practitioner‐led services have been reported as more effective than physician‐led services at increasing patient adherence to evidence‐based recommendations. However, nurse practitioner‐led programmes are uncommon and there appears to be no current evidence examining the impact of these programmes on attendance/completion rates. Methods A retrospective audit of the Country Access to Cardiac Health (CATCH) database was undertaken to identify patients who attended a nurse practitioner‐led cardiac rehabilitation programme between April 2014 and May 2016. Data from key performance indicators were exported to Stata/SE 15.0. The study utilised the Strengthening the Reporting of OBservational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies to ensure quality reporting during this study (See Data S1). Results Seventy‐seven per cent (n = 199) of participants were men, and participants had a mean age of 67 years. Half (52.5%) of participants completed all CR sessions. Male participants (78%) were more likely to complete the CR programme as compared with women (67%). Participants with a family history of cardiovascular disease and a higher number of risk factors at baseline were more likely to commence and complete the programme. Attendance and completion had a positive impact on smoking cessation. Conclusions The nurse practitioner‐led programme evaluated in this study demonstrated high levels of attendance and completion rates compared to standard programmes. This high attendance/completion rate could in turn decrease the rate of subsequent cardiac events and improve mortality and morbidity rates. Relevance to clinical practice provides valuable insights into the effectiveness of nurse practitioner‐led cardiac rehabilitation and secondary prevention on attendance/complete rates. These findings could guide future research and clinical practice development.

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Section: Introductionsupporting

confidence: 90%

Exploration of a nurse practitioner‐led phase two cardiac rehabilitation programme on attendance and compliance

O’Toole¹,

Chamberlain

Giles

2019

Journal of Clinical Nursing

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“…571 However, several studies have also indicated that cardiac rehabilitation uptake is low in patients with DM. 571,572 Patient-centred care in DM…”

Section: General Aspectsmentioning

confidence: 99%

The 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD

Grant

Cosentino

2019

European Heart Journal

384

331

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“…This guidance statement is aimed at helping front-line practitioners better manage the growing number of cardiac rehabilitation participants who have diabetes. (1) It has been developed and written by a group of practitioner-academics with a special interest in how diabetes management interacts with their practices in cardiology (3 authors), dietetics (1 author), rehabilitation therapy (1 author) or exercise science applied to metabolic care (2 authors). All of the authors have previous experience in contributing to national and international practice guidelines/standards in either cardiac rehabilitation and/or diabetes.…”

Section: Introduction and Aimsmentioning

confidence: 99%

Acute glycaemic management before, during and after exercise for cardiac rehabilitation participants with diabetes mellitus: a joint statement of the British and Canadian Associations of Cardiovascular Prevention and Rehabilitation, the International Council for Cardiovascular Prevention and Rehabilitation and the British Association of Sport and Exercise Sciences

et al. 2020

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Type 1 (T1) and type 2 (T2) diabetes mellitus (DM) are significant precursors and comorbidities to cardiovascular disease and prevalence of both types is still rising globally. Currently,~25% of participants (and rising) attending cardiac rehabilitation in Europe, North America and Australia have been reported to have DM (>90% have T2DM). While there is some debate over whether improving glycaemic control in those with heart disease can independently improve future cardiovascular health-related outcomes, for the individual patient whose blood glucose is well controlled, it can aid the exercise programme in being more efficacious. Good glycaemic management not only helps to mitigate the risk of acute glycaemic events during exercising, it also aids in achieving the requisite physiological and psycho-social aims of the exercise component of cardiac rehabilitation (CR). These benefits are strongly associated with effective behaviour change, including increased enjoyment, adherence and self-efficacy. It is known that CR participants with DM have lower uptake and adherence rates compared with those without DM. This expert statement provides CR practitioners with nine recommendations aimed to aid in the participant’s improved blood glucose control before, during and after exercise so as to prevent the risk of glycaemic events that could mitigate their beneficial participation.

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An analysis of barriers to entry of cardiac rehabilitation in patients with diabetes: Using data from the National Audit of Cardiac Rehabilitation

Cited by 16 publications

References 13 publications

Exploration of a nurse practitioner‐led phase two cardiac rehabilitation programme on attendance and compliance

Exploration of a nurse practitioner‐led phase two cardiac rehabilitation programme on attendance and compliance

The 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD

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