Home based cardiac rehabilitation could improve outcomes

doi:10.1136/bmj.b1921

Published 12 May 2009, doi:10.1136/bmj.b1921
Cite this as: BMJ 2009;338:b1921

Letters

Deprivation and prognosis

Home based cardiac rehabilitation could improve outcomes

The first 100% of the full text of this article appears below.

Denvir and Zamvar cite practical problems in attending cardiacrehabilitation after cardiac surgery as a barrier for uptakein poorer patients.¹ Two recent randomised controlled trialscompared a six week, nurse facilitated home based programmewith group based hospital based rehabilitation and found similarclinical and cost outcomes.² ³ ⁴ Through offering patients achoice of these methods we have been able to meet the coronaryheart disease national service framework target of 85% of suitablepatients taking part in cardiac rehabilitation, a strategy explicitlyrecommended in the latest commissioning guidance from the NationalInstitute for Health and Clinical Excellence (NICE).⁵

Home delivery of cardiac rehabilitation solves several practicalproblems in attending a hospital programme and may amelioratethe effects of inequity.

Cite this as: BMJ 2009;338:b1921

Hasnain M Dalal, general practitioner¹, Jenny Wingham, research nurse², Philip Evans, senior clinical research fellow³, Rod Taylor, associate professor in health services research³, John Campbell, professor of general practice and primary care³

¹ Lower Lemon Street Surgery, Truro TR1 2LZ, ² Royal Cornwall Hospital, Truro TR1 3LJ, ³ Peninsula Medical School (Primary Care), Exeter EX1 2LU

hmdalal@doctors.net.uk

Competing interests: None declared.

Denvir MA, Zamvar V. Social deprivation and poor prognosis after cardiac surgery. BMJ 2009;338:b721. (2 April.)[Free Full Text]
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Taylor RS, Watt A, Dalal HM, Evans PH, Campbell JL, et al. Home-based cardiac rehabilitation versus hospital-based rehabilitation: a cost effectiveness analysis. Int J Cardiol 2007;119:196-201.[CrossRef][Web of Science][Medline]
National Institute for Health and Clinical Excellence. Cardiac rehabilitation service. Available at: www.nice.org.uk/usingguidance/commissioningguides/cardiacrehabilitationservice/CardiacRehabilitationService.jsp