Cardiac rehabilitation uptake following myocardial infarction: cross-sectional study in primary care.
BACKGROUND
Policies suggest that primary care should be more involved in delivering cardiac rehabilitation. However, there is a lack of information about what is known in primary care regarding patients' invitation or attendance.


OBJECTIVE
To determine, within primary care, how many patients are invited to and attend rehabilitation after myocardial infarction (MI), examine sociodemographic factors related to invitation, and compare quality of life between those who do and do not attend.


METHODS
Review of primary care paper and computer records; cross-sectional questionnaire.


METHODS
Northern Ireland general practices (38); stratified sample, based on practice size and health board area.


METHODS
Patients, identified from primary care records, 12-16 weeks after a confirmed diagnosis of MI, were posted questionnaires, including a validated MacNew post-MI quality-of-life questionnaire. Practices returned anonymised data for non-responders.


RESULTS
Information about rehabilitation was available for 332 of the 432 patients identified (76.9%): 162 (37.5%) returned questionnaires. Of the total sample, 54.4% (235/432) were invited and 37.0% (160/432) attended; of those invited, 68.1% (160/235) attended. Invited patients were younger than those not invited (mean age 63 years [standard deviation SD 16] versus 68.5 years [SD 16]); mean difference 5.5 years (95% confidence interval [CI] = 1.7 to 9.3). Among questionnaire responders, those who attended were younger and reported better emotional, physical, and social functioning than non-attenders (P = 0.01; mean differences 0.44 (95% CI = 0.11 to 0.77), 0.48 (95% CI = 0.10 to 0.85) and 0.54 (95% CI = 0.15 to 0.94) respectively).


CONCLUSIONS
Innovative strategies are needed to improve cardiac rehabilitation uptake, integration of hospital and primary care services, and healthcare professionals' awareness of patients' potential for health gain after MI.
Centre of Excellence for Public Health (NI), Queen's University Belfast, Northern Ireland. m.cupples@qub.ac.uk
Margaret E
ME
Cupples
Mark A
MA
Tully
Martin
M
Dempster
Mairead
M
Corrigan
Damian O
DO
McCall
Bernadette
B
Downey
D000328:Adult; D000367:Age Factors; D000368:Aged; D004812:Epidemiologic Methods; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000534:rehabilitation*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011788:Quality of Life