ABSTRACT
Evidence from two audits has suggested room for improvement in provision in the UK.58,59
There was poor adherence to published guidelines with respect to content and delivery of cardiac rehabilitation. Staff involvement was mainly limited to nurses, dieticians and physiotherapists with under-representation of physicians, psychologists, occupational therapists, social workers and vocational counsellors. Blood pressure and lipid measurements were commonly recorded (about three quarters of centers) although figures obtained were not always up-to-date and were not necessarily reassessed to establish ideal goal attainment. Fewer centers provided a validated assessment of weight, diet, smoking, anxiety and depression, stress, sleep or sexual functioning. As is commonly found, only a small majority of eligible patients attended cardiac rehabilitation and some patients were excluded by age limitations on some programs. Although core components, such as exercise training, relaxation and education, were included in many programs, this was not
always at a beneficial level. Reassessment of current provision should reveal improvement. Adherence to published guidelines should eliminate intercenter variation and should ensure that interventions are delivered at a beneficial level.
