Study finds many heart patients are missing out on cardiac rehab

If you have received a cardiac stent or had heart bypass surgery, Sherry Grace, a professor at York University in Toronto and University Health Network, says the next step should be cardiac rehabilitation.

Patients typically receive 36 hours of cardiac rehabilitation, usually in one-hour sessions.

"So, cardiac rehab results in 20% less death in patients that attend," Grace says.

Grace, an expert in cardiac rehabilitation, says these programs meet patients where they are, offering not just a supervised, safe way to become physically active, but also health education, nutritional counseling, and mental health support.

"About 1 in 5 heart patients have depression," Grace says. "There are really high rates of anxiety. You know, some anxiety is normal, right? You've just had a heart event. But those conditions really impact a patient's ability to follow the exercise advice and the nutrition advice. So, the programs where that's addressed to patients really do a lot better."

Grace says patients who participate in cardiac rehab tend to enjoy it.

"Once we get them in the door, they're very happy to keep coming," she says.

But, a recent survey of 2,000 heart patients from 16 countries led by Grace found many heart patients are not getting cardiac rehab.

Even in North America, which has higher levels of participation than other regions, only about 30% of heart patients are receiving rehab, Grace says.

Their study, she says, looked at why patients are missing out on this part of their recovery.

"Overall, the highest barriers were not even knowing that rehab existed, and then cost and distance," Grace explains. "In the United States, there are co-pays for each session. So, that can be quite a barrier for patients."

Researchers found women are less likely than men to be referred for cardiac rehab.

Grace says an automatic referral system, leveraging electronic health records, might keep patients from falling through the cracks.

"So, say you're a heart patient with a stent or a bypass," she explains, "we know that you would benefit from rehab. So, a flag comes up to the physician [looking at your record], asking 'Refer this patient to rehab?' They just have to hit, 'yes.' So, it's top of mind, and you make it easy for them to do that, and then no one gets lost."  

To draw in more women, Grace says, programs should let them choose exercise they enjoy.

"Making sure that they are really getting what they need, and then they are more likely to keep coming back," she says.