Patients' perspectives on cardiac rehabilitation, lifestyle change and taking medicines: implications for service development

Objectives: Cardiac rehabilitation programmes offer eligible coronary heart disease patients information on lifestyle modification and medicines. Our aim was to understand patients' perspectives on these topics. Methods: In-depth qualitative interviews were conducted and audiotaped with 15 patients approximately three months after hospital discharge, after they had completed a hospital-based cardiac rehabilitation programme. Repeat interviews with ten patients explored whether their perspectives had changed when interviewed again approximately nine months later. Results: Patients tended to talk about the exercise component of cardiac rehabilitation and only talk about the information provision component when prompted, which suggested they viewed the programme as being primarily about exercise. They seemed to have little subsequent contact with health services, except routine six-monthly check-ups for their coronary heart disease. Unmet information needs were common, especially about medicines. Nevertheless, all patients reported continuing to take cardiac medicines, but tended to only maintain changes to aspects of lifestyle perceived as causes of coronary heart disease, rather than viewing lifestyle recommendations as standards to achieve. Conclusion: Ensuring that individual patients' information needs about medicines and lifestyle are adequately met remains a key focus for cardiac rehabilitation development. Key aspects include individualizing information and actively seeking and responding to patients' needs during and after cardiac rehabilitation.