This 4th edition of BACPR Standards and Core Components (SCC) has greater emphasis on the need for a person-centred approach for cardiovascular prevention and rehabilitation programmes (CPRPs). Patients should be afforded the opportunity to engage with the sum of coordinated cardiac rehabilitation activities as outlined in the five core components to enhance their health, wellbeing and outcomes. The six standards remain with greater emphasis on offering patients a choice of when, where and how their CPRP is delivered to ensure their individual needs are met. Guided by the evidence, the SCC are also more inclusive of all patient populations who may benefit from a cardiovascular prevention and rehabilitation programme.
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Milkfairy
Heart Star
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The standards now recommends that patients living with Non obstructive coronary artery disease NOCAD, Spontaneous coronary artery dissection SCAD, Atrial fibrillation and Peripheral artery disease PAD may benefit from Cardiac Rehab
that’s is really positive news, when it’s not an “obvious issue” / common heart issue (especially with NOCAD) not only does it take ages to be diagnosed, soul destroying to be disbelieved repeatedly and have the pain for self advocacy at the same time as physical pain, your also left to your own devices without much support. Sorry got a bit soap boxy. You know all this better than myself, Thanks for the link above, will definitely read. 👍
Very interesting publication, thanks for the link.
The first chapter is available for a free download, and contains a powerful little nugget,
"Of the four risk factor goals most strongly associated with long‐ term survival, three were lifestyle variables (not smoking, physical activity, and healthy diet), and the fourth variable (systolic blood pressure) was influenced by health behaviours"
So this stuff really does matter!
Furthermore, the report discusses a dimension of life-style changes that I'd not previously considered. It says life style changes, as well as "adding years to life" can also "add life to years". In other words, a healthier life style may allow you live longer, but it also allows you to live better.
So double the reason to stick with those New Year's Resolutions!
Thank you for posting this, and pointing to the specific document which, I agree, is a really helpful guide and framework for thinking about Cardiac Rehab.
At the Aortic Dissection Awareness UK and Ireland meeting last October, one of the items that came up on people's wish-lists after aortic surgery is, definitely, Cardiac Rehab.
Although the document doesn't directly address this case, the reality is that some Cardiac Rehab programmes do already accept people who have been through aortic surgery. The reference to 'adult congenital heart disease' might be understood as including this ... and, as you point out, dissections of the coronary artery (SCADs) are mentioned.
Where abdominal aortic aneurysms are concerned, which are strongly smoking-associated and part of the cardiovascular diseqse spectrum, there would seem to be every reason to include the patients in cardiac rehab, and the standard framework would seem to apply without any real issues.
With genetically-driven ascending aortic aneurysms, I can see some possible differences in terms of dietary advice, though blood pressure control is just as important as for cardiovascular disease. There's also definitely a risk of atrial fibrillation and a need to manage that.
Above all, especially with dissections, I think there's an issue around deconditioning and loss of confidence around exercise which, for me, is one of the central gains for anybody accessing Cardiac Rehab, in whatever format is offered.
Thank you for sharing this document which provides evidence for the wider use of cardiac rehab, with particular reference to NOCAD.
I hope that it is implemented and adopted widely. However, given the current circumstances I suspect that it will not be a priority . It will be important for those of us affected by conditions for which rehab is not routinely offered to bring this to the attention of relevant authorities, groups and individuals.
I wrote to my local Trust after my heart attack noting my concerns that there was no longer a Cardiac Rehab programme provided. I was told that they have adopted an 'individualized' approach and that if I felt I needed help there were a variety of services they could refer me on to - eg: physio (although their time is limited and I would need to be very needy for them to do this) doing well teams for weight loss or psychological support, dieticians etc. There was no recognition of the value of peer support that might be gained from a rehabilitation programme. I was quite disappointed by this approach although I accept that some people may prefer it. I have felt quite isolated and lonely and have really felt the need for someone with a similar experience to relate to. (I'm also grateful for on-line forums such as this but it can't replace meeting people face-to-face).
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another pointless appointment
Heart attack, 6 month on
MVA - Spasms and Exercise
