Data from: Why do so few patients with heart failure participate in cardiac rehabilitation? A cross-sectional survey from England, Wales and Northern Ireland

OBJECTIVES: To determine why so few patients with chronic heart failure in
England, Wales, and Northern Ireland take part in cardiac rehabilitation.
DESIGN: Two-stage, postal questionnaire-based, national survey.
PARTICIPANTS AND SETTING: Stage 1: 277 cardiac rehabilitation centres in
England, Wales, and Northern Ireland registered on the National Audit of
Cardiac Rehabilitation register in 2009–10. Stage 2: 35 centres that
indicated in stage 1 that they provide a separate cardiac rehabilitation
programme for patients with heart failure. RESULTS: Full data were
available for 224/277 (81%) cardiac rehabilitation centres. Only 90/224
(40%) routinely offered phase 3 cardiac rehabilitation to patients with
heart failure. Of these 90 centres that offered rehabilitation, 43% did so
only when heart failure was secondary to myocardial infarction or
revascularisation. Less than half (39%) had a specific rehabilitation
programme for heart failure. Of those not providing for patients with
heart failure, 134/224 (60%) considered a lack of resources and 89/224
(40%) exclusion from commissioning contracts as the reason for not
recruiting patients with heart failure. Overall, only 35/224 (16%) centres
provided a separate rehabilitation programme for people with heart
failure. CONCLUSION: Patients with heart failure as a primary diagnosis
are excluded from most cardiac rehabilitation programmes in England,
Wales, and Northern Ireland. A lack of resources and direct exclusion from
local commissioning agreements are the main barriers for not offering
rehabilitation to patients with heart failure.