Article Text
Abstract
Background Cardiac rehabilitation (CR) is a well-evidenced and effective secondary intervention proven to reduce mortality and readmission in patients with cardiovascular disease. Improving physical fitness outcomes is a key target for CR programmes, with supervised group-based exercise dominating the mode of the delivery. However, the method of traditional supervised CR fails to attract many patients and may not be the only way of improving physical fitness.
Methods Using real-world routine clinical data from the National Audit of Cardiac Rehabilitation across a 5-year period, this study evaluates the extent of association between physical fitness outcomes, incremental shuttle walk and 6 min walk test, and mode of delivery, delivered as traditional supervised versus facilitated self-delivered.
Results The proportion of patients receiving each mode were 80.6% supervised with 19.4% to self-delivered. The study analysis comprised of 10 142 patients who were included in the two models. The self-delivered group contained a greater proportion of females and older patients. The regression model showed no clinical or statistical significance between mode of delivery and post-CR physical fitness outcomes.
Conclusions This study is unique as it has identified through a routine clinical population that regardless of the mode of delivery of rehabilitation, patients improve their physical fitness outcomes at meaningful levels. This study provides a strong evidence base for patients to be offered greater choice in the mode of CR delivery as improvements in physical fitness are comparable.
- exercise
- cardiac rehabilitation
- physical health
- secondary prevention
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Footnotes
Contributors All included authors made valuable and significant contributions to the article. The NACR team acknowledged in the paper added in the access of the data but were not part of the design, writing or processing of the manuscript. This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Funding This research was carried out by the British Heart Foundation (BHF) Cardiovascular Health Research Group which is supported by a grant from the BHF (R1680901).
Competing interests None declared.
Patient consent Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The data used in the research is linked anonymised data, given access to the University of York and the NACR from NHS DIgital under section 251. The data in this form cannot be uploaded to a shareable platform due to its not true anonymised form.