Key result
Only 37% of post-myocardial infarction patients attended cardiac rehabilitation, but those who did attend reported significantly better physical, emotional, and social functioning than non-attenders.
Cross-Sectional (n=432)
Yes
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A significant proportion of post-MI patients are not invited to or do not attend cardiac rehabilitation, highlighting a communication gap between hospital and primary care services, while those who do attend report better quality of life.
BACKGROUND: Policies suggest that primary care should be more involved in delivering cardiac rehabilitation. However, there is a lack of information about what is known in primary care regarding patients' invitation or attendance. AIM: To determine, within primary care, how many patients are invited to and attend rehabilitation after myocardial infarction (MI), examine sociodemographic factors related to invitation, and compare quality of life between those who do and do not attend. DESIGN OF STUDY: Review of primary care paper and computer records; cross-sectional questionnaire. SETTING: Northern Ireland general practices (38); stratified sample, based on practice size and health board area. METHOD: Patients, identified from primary care records, 12-16 weeks after a confirmed diagnosis of MI, were posted questionnaires, including a validated MacNew post-MI quality-of-life questionnaire. Practices returned anonymised data for non-responders. RESULTS: Information about rehabilitation was available for 332 of the 432 patients identified (76.9%): 162 (37.5%) returned questionnaires. Of the total sample, 54.4% (235/432) were invited and 37.0% (160/432) attended; of those invited, 68.1% (160/235) attended. Invited patients were younger than those not invited (mean age 63 years [standard deviation SD 16] versus 68.5 years [SD 16]); mean difference 5.5 years (95% confidence interval [CI] = 1.7 to 9.3). Among questionnaire responders, those who attended were younger and reported better emotional, physical, and social functioning than non-attenders (P = 0.01; mean differences 0.44 (95% CI = 0.11 to 0.77), 0.48 (95% CI = 0.10 to 0.85) and 0.54 (95% CI = 0.15 to 0.94) respectively). CONCLUSION: Innovative strategies are needed to improve cardiac rehabilitation uptake, integration of hospital and primary care services, and healthcare professionals' awareness of patients' potential for health gain after MI.
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Cupples et al. (2010) conducted a cross-sectional in Myocardial infarction or acute coronary syndrome (n=432). Cardiac rehabilitation attendance vs. Non-attendance was evaluated on Physical functioning quality of life (MacNew post-MI questionnaire) (MD 0.48, 95% CI 0.10 to 0.85, p=0.01). Only 37% of post-myocardial infarction patients attended cardiac rehabilitation, but those who did attend reported significantly better physical, emotional, and social functioning than non-attenders.
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