Clinical outcomes in cardiac rehabilitation patients
Research type
Research Study
Full title
Clinical outcomes in patients being referred to cardiac rehabilitation
IRAS ID
135987
Contact name
Christos Lykidis
Contact email
Sponsor organisation
Sandwell and West Birmingham Hospitals NHS Trust
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Coronary heart disease (CHD) is the leading cause of mortality in the UK and is associated with substantial costs. Cardiac rehabilitation (CR), which is the process by which CHD patients are encouraged to achieve their full potential in terms of physical and psychological health, involves a combination of education, psychological support, exercise training and behavioral change. CR is part of the standard care post-CHD event according to the national guidelines that were based on dated randomized controlled trials (RCTs) evidencing decreases in mortality and hospital re-admissions.
A recent multi-centre UK trial posed concerns about the effectiveness of CR showing no effect on mortality. However, interpretation of the above finding is problematic given the trial’s important methodological issues as well as the low duration of the participating programmes. It had previously been highlighted that the exercise dose typically encompassed in UK CR programs was relatively low compared to that from the RCTs. This had led to the suggestion that current CR programs were unlikely to be as effective as the clinical trials. This was supported by later research evidencing only mild fitness improvements being induced by UK CR programs.
Therefore it has been suggested that further studies are needed to determine the efficacy of UK CR programs. To address this, we aim to analyze existing data accumulated as part of the standard care offered to CHD patients who were suitable for exercise-based CR at City Hospital in Birmingham between 2010 and 2012. Rates of unplanned hospital re-admissions and mortality will be compared in these patients who will be categorised according to their attendance to the CR programme (i.e. ‘completers’ - ‘partial completers’ – ‘decliners’). This will allow a comprehensive assessment of the effectiveness of a large UK-based CR program and provide information that is pivotal in remodeling and commissioning CR services.REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
15/SW/0081
Date of REC Opinion
20 Mar 2015
REC opinion
Favourable Opinion