A ‘one size fits all’ approach doesn’t work for cardiac rehab patients – Richard Forsyth

Despite this, most programs rose to the challenge head-on and quickly introduced innovative approaches to assessment, exercise, and support for people who had just had a cardiac event, procedure, or diagnosis. Due to the natural delay in developing the amended guidelines and research evidence, services have had to implement a combination of existing digital and home resources while simultaneously developing “in-house” materials.

What was meant to be a relatively short-term adaptation turned into ongoing change and instability, driven by continued labor shortages, loss of clinical and gymnasium spaces, implementation of social distancing measures social, local and national lockdowns and multiple spikes in infection rates.

However, it also provided a number of opportunities. This period of testing and learning new approaches has prompted services to completely rethink the ways in which cardiac rehabilitation is delivered and to embrace new technologies.

Richard Forsyth, Health Systems Knowledge Manager, British Heart Foundation Scotland

To find out more about the patient experience, the British Heart Foundation heard from over 200 people in an online survey who took part in Cardiac Rehab between August 2020 and February 2022 and held two focus groups in June this year.

The survey asked them to describe how they engaged in their cardiac rehab program and, given the choice, what would have been their preferred mode of delivery – face-to-face, virtual, or over the phone? Have they used any form of technology and found it useful? Did they have the opportunity to interact with other people in rehab at the same time?

Our analysis revealed that only 40% of people received an in-person assessment, while 73% of people would have preferred this mode of engagement. Just under one in four patients (24%) were able to include a family member or friend as part of their initial consultation and almost 60% of patients did not have the opportunity to connect with others in rehabilitation.

Not surprisingly, during this period, 76% of patients used some form of technology during their program, ranging from virtual consultations to home blood pressure monitors and smartwatches to mobile apps. The user experience varied, with some finding it empowering and a safe way to monitor heart rate and blood pressure, while others found it overwhelming and confusing.

What the breadth of patient knowledge has told us is that it is clear that a one-size-fits-all, one-size-fits-all approach to moving forward is not advisable. Patients are eager to embrace new technologies, to build a rehabilitation program that is flexible and sensitive to their personal situation and preferences.

If we can take one positive from the past two years, it should be the resilience and versatility demonstrated by our NHS colleagues and the new offerings we now have in Cardiac Rehab that have the potential to improve uptake and to ensure clinical quality. maintained.

The pandemic has presented us with an unprecedented opportunity to create a new and robust foundation for hybrid cardiac rehabilitation delivery to address inequities, develop and expand eligibility criteria, and support groups underserved to engage with local teams across the UK. Now is the time to make it a reality.

Richard Forsyth, Health Systems Knowledge Manager, British Heart Foundation Scotland

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