Cardiac rehabilitation for patients with heart failure: A service development audit

Background: Chronic heart failure (CHF) is a growing public health problem. Interventions such as drug treatments education and specialist nurse involvement have all improved outcomes. Evidence suggests tailored exercise programmes reduce hospitalization levels and improve mortality. National and international guidelines recommend that exercise programmes form part of an overall care package for patients with CHF. However, conventional cardiac rehabilitation services have been reluctant to prescribe exercise for this group of patients. Objectives: The aims were to investigate whether tailored classes for patients with CHF can be provided safely and without excessive costs and whether they can improve quality of life. Methods: Patients attending the nurse-led heart failure clinic were assessed for their suitability for cardiac rehabilitation. Those considered suitable were invited to attend an exercise-based cardiac rehabilitation programme lasting between 14 and 16 weeks. Twelve patients took part and they were divided into two groups. Baseline physiological and psychological assessments were undertaken at the beginning of the programme and these were reasessed at the end using the Borg and the Hospital Anxiety and Depression Scales. Results: Both groups showed improvements in exercise performance. As a result their ability to perform routine daily tasks was improved. In addition, some of the patients showed reduced levels of anxiety, 82% of patients felt that the programme helped them deal with their problems and some patients reported increased confidence levels. Conclusions: Cardiac rehabilitation can be provided safely for patients with CHF. The classes produced improved physical and psychological wellbeing for the patients. More research is needed into the benefits of cardiac rehabilitation for patients with heart failure.