Authors' objectives:

This report aims to answer the following questions:

1. Does cardiac rehabilitation reduce mortality and morbidity, and help restore or improve the physical and psychological status of patients after heart attacks?

2. Which components of cardiac rehabilitation are the most effective and how should they be delivered? The components include exercise, patient education, psychosocial interventions and (overlapping with secondary prevention) risk factor modification.

3. What other factors, such as location, influence the uptake, persistence with, and hence the effectiveness of cardiac rehabilitation?

4. Should cardiac rehabilitation be provided to other groups such as patients who are waiting for, or have had CABG?

Authors' recommendations: 1. Cardiac rehabilitation is worthwhile and cost-effective compared to other NHS activities, if provided efficiently. We recommend that it should be available throughout Scotland, tailored to local circumstances, and resourced by the NHS. 2. Cost-effectiveness is improved by group sessions and economies of scale, but not all patients like group sessions. 3. Programmes should offer a menu-based individualised package, and should be coordinated with other aspects of cardiac care. 4. Psychological support of various kinds improves outcomes, but there is insufficient evidence to say whether any particular form of intervention is best. 5. Patient and family education is effective but needs to avoid over-complex terminology. The Heart Manual has been shown to be effective and is widely used. 6. Cardiac rehabilitation is provided mainly to patients who have had heart attacks but also appears useful for those with angina and after CABG. 7. There is probably also a case for intervention for those waiting for CABG. There is a need for further research into the components of the rehabilitation package.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.nhsconfed.net/shpic/doc18.htm

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Scotland, United Kingdom

Organisation Name: Scottish Health Purchasing Information Centre

Copyright: Scottish Health Purchasing Information Centre