Cardiac rehabilitation in the UK: uptake among under-represented groups

The National Service Framework for coronary heart disease (CHD) states that cardiac rehabilitation should be provided for all patients who may benefit, and that priority should be given in the first instance to those who have survived a myocardial infarction (MI) or undergone revascularisation. 1 This was recently endorsed by the fifth report on the provision of services for patients with heart disease. 2 Previous surveys of provision of cardiac rehabilitation in the UK have shown that patients attending such programmes tend to be male, middle aged, and diagnosed with uncomplicated MI. 3 Little is known of the current UK provision of cardiac rehabilitation or adherence to such programmes in those from traditionally under-represented groups. Table 1 Referral, uptake and completion rates for UK cardiac rehabilitation programmes in the year 2000 Median IQR Range *Number of programmes % of referrals All patients Referred 271 164-424 2-1564 156 Joined 172 101-254 2-1066 153 63 Completed 130 75-186 3-450 133 48 MI patients Referred 160 78-286 0-881 97 Joined 91 49-149 0-446 88 57 Completed 66 31-103 0-425 69 41 Revascularisation patients Referred 86 47-142 0-563 91 Joined 50 22-99 0-407 83 58 Completed 45 13-82 0-367 65 52 Male patients Referred 213 111-334 2-1066 83 Joined 118 66-185 2-747 84 55 Completed 84 43-154 2-329 65 39 Female patients Referred 85 36-130 1-498 83 Joined 36 17-60 1-319 84 42 Completed 27 12-45 0-140 65 32 Patients over 65 years old Referred 142 61-228 0-887 66 Joined 72 37-152 0-596 71 51 Completed 54 30-110 4-212 51 38 Black/Asian patients Referred 5 1-19 0-196 59 Joined 2 0-7 0-127 63 Completed Heart failure patients Referred 0 0-2 0-28 61 Joined 0 0-1 0-12 59 Completed 0 0-1 0-9 46 Angina patients Referred 6 0-27 0-200 71 Joined 1 0-8 0-134 70 Completed 0 0-5 0-73 51 *Data were not provided for all questions by all services so the numbers of respondents to each question are provided of a possible maximum of 191.