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Heart rehabilitation services neglect women

Only third of women start rehab after heart attack or bypass surgery

Adrian O'Dowd

Tuesday, 15 December 2015

Only around a third (38%) of female patients who have had a heart attack, angioplasty or bypass surgery receive any cardiac rehabilitation help in England, Wales and Northern Ireland, according to a report published today.

The National Audit of Cardiac Rehabilitation Annual Statistical Report 2015 said that more 24,000 female heart patients were currently missing out on crucial rehabilitation, thus putting them at risk of having further heart attacks.

Health commissioners, including CCGs, and service providers have now been asked to take steps to ensure that more women are motivated to attend rehabilitation programmes.

The National Audit of Cardiac Rehabilitation (NACR), which is funded by the British Heart Foundation (BHF) and hosted at the University of York, combined data from 164 centres in England, as well as centres in Wales and Northern Ireland.

It showed that cardiac rehabilitation services are neglecting female heart patients, with just over 14,000 taking part in cardiac rehabilitation out of 38,500 eligible female patients in England in 2013-14.

A further 5,500 women could take part if services fixed the current gender imbalance and matched male uptake levels (52%), said the authors.

After experiencing a major heart event such as a heart attack and having life-saving surgery or medicine-based treatment, a person should be referred for rehabilitation to help their recovery and reduce the risk of another heart attack.

Cardiac rehabilitation involves offering physical activity support and lifestyle advice, such as exercise classes and dietary guidance, to help people living with heart disease manage their condition and reduce their risk of associated heart events.

It is estimated that rehabilitation can help reduce the number of deaths by 18% over the first six to 12 months and can cut readmissions by around a third (31%).

The report says that in England, around 122,000 patients are eligible for cardiac rehabilitation but only 47% receive it, despite a government target of 65% uptake.

At some rehabilitation centres, as few as 10% of patients are women, partly because services are failing to refer and encourage female patients to take part, said the authors, who also had concerns that older women and men were not attending cardiac rehabilitation following a medically managed heart attack.

Dr Mike Knapton, associate medical director at the BHF, said: “It is appalling that less than half of eligible female heart patients receive cardiac rehabilitation. Thousands of women are missing out on a vital step in their recovery, increasing their risk of another heart attack.

“That’s why health services urgently need to make rehabilitation more accessible to women, who are either not referred or are put off attending, to help save more lives.”

Professor Patrick Doherty, NACR director, said: “This report shows that while some programmes promote an attractive rehabilitation service and have really high uptake of female patients, the majority of programmes struggle to ensure enough women take part.

“Service providers and commissioners should take action to improve the appeal of the programmes and promote them in a way that motivates female patients to attend. A range of options should be offered including community and self-management approaches, all of which have been shown to benefit patients.”

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