Too Few Heart Patients Go to Cardiac Rehab

MONDAY Feb. 14, 2011 -- Heart disease patients are far more likely to undergo cardiac rehabilitation if they are given an automatic referral after discussing the matter with their doctor, a new study finds.

Evidence shows that cardiac rehabilitation reduces illness and death by about 25 percent over one to two years. However, 70 percent to 80 percent of eligible heart disease patients in Canada, the United States and United Kingdom do not receive cardiac rehabilitation after hospital discharge, according to background information in the study.

Researchers surveyed more than 2,600 patients with coronary artery disease who were treated at 11 Canadian hospitals that used one of four referral strategies for cardiac rehabilitation: an automatic referral using electronic patient records or standard discharge orders; liaison referral, in which the referral occurs after a discussion with a doctor; a combination of both automatic and liaison strategies; or usual referral, in which certain patients are referred at the discretion of a doctor.

Patients who were automatically referred after talking with their doctors were the most likely to enroll in rehab, according to the study.

More than 70 percent of patients who received the combined automatic/liaison referral enrolled in rehabilitation compared to 60 percent with automatic referral alone, nearly 51 percent with liaison alone and 29 percent when referral was left up to the doctor's discretion.

The combined automatic/liaison method may be most effective because it relies on both the automatic referral and because patients and doctors are involved. The discussion allows patients to get their questions answered and may make them more willing to try cardiac rehabilitation, according to study author Sherry Grace of York University in Toronto and her colleagues.

"Implementation [of the combined strategy] could potentially raise cardiac rehabilitation use 45 percent, suggesting that major public health gains could be achieved in the population being treated for cardiac disease," the authors concluded.

The study is published in the Feb. 14 issue of the Archives of Internal Medicine.

More information

The U.S. National Heart, Lung, and Blood Institute has more about cardiac rehabilitation.

Posted: February 2011


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