A UK survey of phase I cardiac rehabilitation for patients with acute coronary syndrome

Objectives This study investigated phase I cardiac rehabilitation (PlCR) for patients admitted with acute coronary syndrome and is the first to investigate PICR in the UK in depth. The aims were to investigate the UK and any national differences in the provision, staffing, content of PICR, national guidelines achieved and any identified barriers. Design A self-completion questionnaire was posted to the cardiac rehabilitation centres on the databases of the British Association for Cardiac Rehabilitation and the British Heart Foundation in the period of 2004-2005. Participants Two hundred and eighty hospitals in the UK were identified. Main instrument A questionnaire designed by the authors. Results A total of 247 (88%) centres returned the questionnaire. Ninety-three percent of these centres (230) provided PICR for acute coronary syndrome. There was 100% nurse, 63% (145/230) dietician, 59% (135/230) pharmacist and 49% (112/230) physiotherapy involvement but underutilisation of other members of the cardiac rehabilitation healthcare team. Risk stratification to determine future cardiac or exercise complications was not carried out in 27% (59/230) of the PICR centres. Not all 17 cardiac risk education topics were discussed with patients. Fifty-five percent (126/230) provided PICR mobilisation plans and 61% (140/230) provided PICR walking plans. Although 100% identified and consulted national guidelines, many barriers to implementation were identified, with 58% (133/230) citing lack of staff and 31% (71/230) funding. Conclusion Certain areas of PICR need to be addressed to enable equity of evidence-based service. The underachievement of many aspects of the PICR guidelines is of concern. The current study has also shown the need for more research into PICR. (c) 2007 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.