A Nagle*,  J Wiggers, J Fisher,  N Johnson,  K Inder.

National Heart Foundation of Australia,  Newcastle, Discipline of Behavioural Science in Relation to Medicine, Faculty of Medicine and Health Sciences, University of Newcastle; Centre for Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, University of Newcastle; Cardiovascular Medicine Unit, John Hunter Hospital, Hunter Area Health Service,  Newcastle.

In 1977 the NSW Policy Standards for Cardiac Rehabilitation were releasedand recommended that "all cardiac patients should have access to a comprehensive cardiac rehabilitation (CR) programme" including patients with AMI, Valve replacement, CABS, CHF, PTCA/Stents, and Transplants. The AHCPR guidelines (1995) also recommend CR for Stable Angina. The Victorian Human Services Best Practice Guidelines additionally recommend Unstable Angina. The aim of the study is to determine, among the population of public hospital patients, with a discharge diagnosis for which participation in cardiac rehabilitation is recommended (according to the guidelines, the proportion who self reported being invited to attend, attending and completing a Phase II outpatient cardiac rehabilitation programme. Utilising the Hunter Heart and Stroke Register of CVD patients, 2007 eligible patients were recruited to the study. Of the 1244 (62%) consenting patients, 490 (39%) reported being invited to attend a CR programme. Of these 311 (63%) attended at least one session and of these 234 (75%) completed (all or all except one session) a CR programme. Based on discharge diagnosis 53% of AMI and IHD, 32% of UAP, 24% CHF and 19% of Other CVD were invited to attend CR. Overall, of the sample of 1244 patients with a diagnostic category where completion of cardiac rehabilitation is recommended, 19% actually completed a programme. Sociodemographic, diagnosic, and hospital predictors of outcome indicators will also be presented. These findings suggest that access to an effective secondary prevention treatment is less than optimal. Recommendations include the need for ongoing monitoring of participation rates at an Area Health level, enabling benchmarking, quality improvement targets and feedback.

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