Core features of cardiac rehabilitation programs
Cardiac rehabilitation offers the opportunity to identify physical, cognitive, psychosocial and adherence difficulties or limitations, which can then be optimised to improve outcomes. The components of cardiac rehabilitation should be implemented throughout the inpatient phase, early outpatient phase (just after discharge for 8 to 12 weeks) and in the long term.
The core components of cardiac rehabilitation programs are:
- an initial medical assessment and explanation of the treatment plan
- nutritional counselling
- risk factor management (including lifestyle modification and medical management)
- provision of a written drug list that includes the indication and intended duration of therapy for each drug to optimise adherence
- psychosocial evaluation to identify mental health issues, sexual health issues, and need for referral for individual or group therapy
- counselling and support to promote behavioural change and address specific patient concerns
- physical activity with exercise prescription
- advice about restarting work, driving and sexual activity
- family or carer reassurance and psychosocial support.
Older people are more likely to have multiple comorbidities requiring optimisation of therapy or diagnosis of conditions.
Cardiac rehabilitation programs are run by a multidisciplinary team of experienced health professionals, in liaison with the patient’s general practitioner. Patients usually attend sessions once a week for 4 to 8 weeks. In some rural and remote areas, alternative models of cardiac rehabilitation may be necessary—see Alternative and evolving models of care.