Treatment Predicts Who Attends Cardiac Rehabilitation- Are We Underplaying CAD that is Medically Managed?

Abstract

Background: Community based cardiac rehabilitation programs are considered best practice post-cardiac event. Uptake of exercise cardiac rehabilitation is generally low across New Zealand, with Tangata whenua and Pacific Islanders most at risk of non-participation. Delivering guideline based exercise programs in the community is also problematic with difficulty in providing sufficient staff with relevant qualifications to support patients. Methods: The cardiac rehabiliation team at the Auckland District Health Board developed a community-based exercise program in the Mt Albert region in partnership with physiotherapists and the local Whanau Ora provider, Te Hononga in July 2015. The program comprises an 8-week program, with twice weekly exercise sessions for 1 hour that is able to accommodate 12 patients per session. The aim was to increase participation of Maori and to incorporate the holistic whanau ora approach to cardiac rehabilitation. Results: Te Hononga have worked alongside ADHB staff to supervise the prescribed exercise program and have helped facilitate Maori and Pacific patients to attend the program. The Te Hononga MDT of Registered Nurses, Lifestyle coaches and social workers in addition provide support through Phase 2 and 3 to Maori and Pacific clients to achieve long-term adherence to lifestyle changes. As this program is run in a community gym, this has empowered patients to continue with exercise in a public gym beyond the phase 2 program. Conclusion: This innovate holistic approach to exercise has facilitated the transition from phase 2 to long-term management of risk factors for heart disease for the most vulnerable patients. The partnership with the Whanau Ora provider has provided a more patient centric approach to the program.