Is cardiac rehabilitation effective in improving quality of life post cardiac event?

Abstract

Cardiac rehabilitation following a cardiac event is a key aspect of patient management and ongoing quality of life. Coronary heart disease (CHD) is one of the leading causes of death in the UK, killing over 110 000 people ( Department of Health (DH), 2005 ). In addition to this, nearly 275 000 people experienced a myocardial infarction with a further 1.4 million people suffering from angina ( DH, 2005 ). The National Service Framework for Coronary Heart Disease outlines the government's intention to improve the care of patients with CHD over a 10-year period ( DH, 2000 ). Standards and NICE guidelines have been developed for the improved prevention, diagnosis, treatment and rehabilitation of people with coronary heart disease. One element is cardiac rehabilitation. The purpose of this article is to appraise current evidence (undertaken within the last 10 years) with regards to the effectiveness of cardiac rehabilitation on improving quality of life post-cardiac event such as myocardial infarction or cardiac surgery/intervention. To achieve this, relevant databases such as CINAHL plus, MedLine and PsycINFO were used to identify appropriate recent research studies: this identified eight studies. The findings within these studies suggests that programmes of shorter duration have a positive impact on quality of life but over time, this impact is not maintained. This could suggest that adherence to cardiac rehabilitation reduces over time. The findings also suggest that cardiac rehabilitation, in people who have undergone bypass grafts or angioplasty, has more of a positive impact on quality of life than in patients who have had a myocardial infarction. There continues to be a key role for cardiac rehabilitation in contemporary health care, and the health-promotion strategies within cardiac rehabilitation may need to focus more on enabling those who have had a cardiac event to take ownership of the interventions embedded within cardiac rehabilitation.