What is cardiac rehabilitation (CR)?

The Seven Core Components for Cardiovascular Disease Prevention and Rehabilitation

Health behaviour change and education
Utilising various evidence-based interventions, CR staff facilitate health behaviour change through the provision of information and support, by addressing misconceptions and illness perceptions, the promotion of self-management, goal setting and problem-solving skills.

Education – The purpose of education is to enhance patient (and spouse / family / friend / carer) knowledge and understanding of their condition, risk factors and management. This helps to restore confidence and sense of personal control. Education should be delivered in a variety of formats and tailored to the individuals needs.

Lifestyle risk factor management
Through evidence-based health behaviour change approaches the MDT support patients to address their physical activity, exercise, dietary and smoking habits.

Psychosocial health
A variety of emotions are experienced by patients participating in CR, and these can contribute to poor outcomes and adherence. Consequently all patients should be screened for anxiety and depression using a valid tool, and appropriate individuals should have access to trained psychological practitioners.

Medical risk factor management
Throughout the patient pathway, CR staff should monitor blood pressure, lipids and glucose and aim to meet national guidelines. This may include the initiation or titration of relevant pharmacological agents.

Cardio-protective therapies
Cardio-protective medication – CR staff should ensure the use of, and adherence to, appropriate cardioprotective medications and their uptitration to evidence-based dosages.

Implantable devices – CR staff can assist in the identification of patients suitable for implantable cardiac defibrillators and / or cardiac resynchronisation therapy, and liaison with specialist staff and services is crucial.

Long-term management
Patient responsibilities – On exit from a individualised CR programme, all patients should be reassessed and their long-term goals identified. Patients should be signposted to appropriate community programmes and services to assist them in the maintenance of their lifestyle changes.
Service responsibilities – Includes reassesment of lifestyle and medical risk factors, psychosocial health and cardioprotective therapies.

Audit & Evaluation
Every cardiac rehabilitation programme should formally audit and evaluate their service. This should include information from individual clinical outcome patient data and data on service performance together with patient satisfaction. This data needs to be in a format that can be shared locally, regionally and nationally. Contributing to scientific publications is also strongly encouraged. The BACPR include the contribution of data to the National Audit for Cardiac Rehabilitation (NACR) as a standard as this plays a key role in influencing and informing national policy.

The British Association for Cardiovascular Prevention and Rehabilitation
Promoting excellence in cardiovascular disease prevention and rehabilitation