Low Referral and Utilisation of Cardiac Rehabilitation in Patients with Heart Failure - European Medical Journal

Low Referral and Utilisation of Cardiac Rehabilitation in Patients with Heart Failure

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RESEARCHERS at the University of Texas Southwestern Medical Center, Dallas, USA, recently investigated the rates of referral and utilisation of cardiac rehabilitation among patients with heart failure and reduced ejection fraction (HFrEF). The study analysed data from participating centres in the American Heart Association Get with the Guidelines® – Heart Failure (GWTG-HF) registry, spanning from January 2010–July 2020, to assess the trends and implications of cardiac rehabilitation in this specific population.

The results revealed a significant implementation gap, with only 24.6% of the eligible patients with HFrEF being referred for cardiac rehabilitation. Although there was a modest increase in the rates of cardiac rehabilitation referral over the years, from 8.1% in 2010 to 24.1% in 2020, utilisation remained strikingly low. Among clinically stable Medicare beneficiaries, 25.8% were referred for cardiac rehabilitation, but only 4.1% of those referred attended the programme, with an average attendance of 6.7 sessions.

The study also identified patient characteristics associated with non-referral, showing that patients who were not referred were more likely to be older, Black, and have a higher comorbidity burden, indicating disparities in access to rehabilitation services.

Despite the low utilisation rates, patients who were referred for cardiac rehabilitation had a lower risk of 1-year death compared to those not referred, suggesting potential benefits associated with participation.

The research team highlighted the need for urgent attention to improve patient referral and participation in cardiac rehabilitation for those with HFrEF. Despite evidence and guideline recommendations, the rates of utilisation remain a challenge. Healthcare providers and systems must implement targeted interventions to bridge this gap, as well as to ensure that more patients can access these essential rehabilitation programmes. Enhancing utilisation of cardiac rehabilitation can lead to improved quality of life and better clinical outcomes for individuals living with heart failure.

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