Uptake of Cardiac Rehabilitation in Te Whatu Ora – Counties Manukau During the Pandemic

Abstract

Cardiac rehabilitation (CR) is an evidence-based range of interventions to support people with several cardiac issues. The impact of the COVID-19 pandemic created many challenges for health services and communities. Using the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZAC-QI) CR database this study tracked referral, mode, and level of engagement from 2013 to 2023. Over 10 years, 9,134 referrals were identified, with a steadily decreasing number every year (1,040 in 2023 vs 672 in 2022; 35% decrease). The majority (70%) was male; mean age for males was 66 years, for females 67 years; and ethnicity was Māori 12%, Pacific 25%, Indian 12%, others 51%. Attendance of any program was 71%, with a 600% increase in clinics vs group interventions. The average uptake of the exercise program was 24%; Māori compared with Pacific and Euro/others (61% vs 71% vs 73%, p>0.001); and younger people (<60 years, 66% vs older >61 years, 73%, p>0.001) were least likely to attend, with no gender differences (male 71% vs Female 69%, p=NS). There has been a significant decline in CR referrals over the last 10 years, with a shift from group-based education to individualised clinic contacts. Uptake of exercise programs remains low. Novel interventions to support Māori and younger patients have been implemented.