Interventions to increase the uptake of cardiac rehabilitation: Systematic review

Cardiac rehabilitation (CR) can significantly reduce mortality and morbidity, yet many patients fail to attend. Aim: Evaluation of interventions designed to increase participation in CR with a secondary focus on under-represented groups. Methods: Systematic review of six electronic databases including randomised controlled trials. Results: Six studies were identified, four of which reported a significant increase in uptake. Two of these interventions used psychological theory-based letters, the third a liaison nurse, and the fourth used a social worker to encourage attendance. The other two studies used peer support or peer support in combination with a nurse. The latter targeted older, unpartnered adults and the study using social worker support targeted blue-collar workers. These were the only two studies addressing potentially under-represented groups. A lack of evidence in that area became apparent. Conclusion: Conclusions must be limited due to the small number of studies. While the effect of peer support is unclear, the impact of additional health-care professional support appears promising. The low cost and risk of adapting invitation letters in line with psychological theory and the considerable health gain of increased participation suggest that CR clinicians should not wait before investigating this method.