Boost for heart rehab
- 2.6 million people are living with heart disease in the UK.
- Being physically active for at least 30 minutes, five days a week is one of the best ways to look after our hearts.
Boost for heart rehab
Physical activity is a crucial part of a healthy lifestyle, but for heart patients it can be especially important in helping to prevent another heart attack and regaining physical wellbeing and confidence.
Recent research has shown that heart patients often find it difficult to take up, and maintain, an exercise regime, but 2005 saw the results of three BHF-funded projects in England, Scotland and Wales, which have boosted rehabilitation and vastly improved exercise programmes for heart attack victims.
Action
Using an innovative ‘action research’ approach, based on the principle of promoting physical activity in the community, the three projects tackled different aspects of the problem.
The project in Bridgend, South Wales, focused on motivational interviewing – a way of working with patients and their families to empower them to decide on lifestyle changes and enable them to make these changes permanent. This was introduced by training all cardiac rehabilitation staff, both in classes and at local leisure centres.
At Battersea in South London the same technique was used, but this time in a primary care setting. All staff, including GPs at 14 surgeries, were trained in how to successfully encourage heart patients to consider increasing physical activity. Ten specialist physical activity clinics were set up where those patients could then learn more about the benefits of lifestyle change.
The Paisley project set out to improve awareness and provision of community-based cardiac rehabilitation services, and develop a ‘buddy network’ that recruited former patients and trained them to help and support new members. The project also set up a new screening service so that GPs could refer heart patients for an exercise tolerance test, to ensure that any physical activity prescription would be appropriate and safe.
Impact
All three projects have been a real success. Both the cardiac team and health visitors who received training at Bridgend have shown significant improvements in using motivational interviewing, and an evaluation and handbook have helped develop further training. Patients felt the team had really helped them make lifestyle changes and, importantly, that they had a choice in deciding what changes to make.
Results in Battersea were also heartening. Nine out of 10 patients surveyed said the clinics helped them become more active and 93% said the clinics were useful in finding out about local opportunities for exercise.
In Paisley, rehabilitation classes rose from five to over 40, with 450 heart patients referred to community-based classes. Eighteen new buddies have helped support 87 patients. Many of those who have joined the buddy network are female, which is important because traditionally women are much more likely to drop out of rehabilitation programmes. To date, 96 patients have been referred through the pre-exercise screening service.
Next steps
In Bridgend the cardiac rehabilitation team will continue to practise the motivational skills they have acquired. In Battersea, 20 members of the primary care teams have attended a training workshop to help continue motivating their patients. And in Paisley the scheme will be picked up by the already established Have a Heart Paisley project, including making the exercise screening service available to all GP surgeries in the area.
In 2006 the BHF will continue to support the National Audit of Cardiac Rehabilitation to measure the effectiveness of rehabilitation services and the benefits to patients by awarding nearly £80,000 to support the audit in Northern Ireland.
Action research - very practical 'on the job' research