DOI: 10.5061/dryad.n6661sh1
title: Data from: Why do so few patients with heart failure participate in cardiac rehabilitation? A cross-sectional survey from England, Wales and Northern Ireland

description: OBJECTIVES: To determine why so few patients with chronic heart failure in
 England, Wales, and Northern Ireland take part in cardiac rehabilitation.
 DESIGN: Two-stage, postal questionnaire-based, national survey.
 PARTICIPANTS AND SETTING: Stage 1: 277 cardiac rehabilitation centres in
 England, Wales, and Northern Ireland registered on the National Audit of
 Cardiac Rehabilitation register in 2009–10. Stage 2: 35 centres that
 indicated in stage 1 that they provide a separate cardiac rehabilitation
 programme for patients with heart failure. RESULTS: Full data were
 available for 224/277 (81%) cardiac rehabilitation centres. Only 90/224
 (40%) routinely offered phase 3 cardiac rehabilitation to patients with
 heart failure. Of these 90 centres that offered rehabilitation, 43% did so
 only when heart failure was secondary to myocardial infarction or
 revascularisation. Less than half (39%) had a specific rehabilitation
 programme for heart failure. Of those not providing for patients with
 heart failure, 134/224 (60%) considered a lack of resources and 89/224
 (40%) exclusion from commissioning contracts as the reason for not
 recruiting patients with heart failure. Overall, only 35/224 (16%) centres
 provided a separate rehabilitation programme for people with heart
 failure. CONCLUSION: Patients with heart failure as a primary diagnosis
 are excluded from most cardiac rehabilitation programmes in England,
 Wales, and Northern Ireland. A lack of resources and direct exclusion from
 local commissioning agreements are the main barriers for not offering
 rehabilitation to patients with heart failure.
description: Cardiac Rehab in HF
 Stage 1 SurveyStage 1 of the national
 survey included all centres that provided phase 3 rehabilitation in
 England, Wales, and Northern Ireland registered on the National Audit of
 Cardiac Rehabilitation (NACR) database funded by the British Heart
 Foundation. Each centre was sent a 17 item, one page postal questionnaire
 that asked respondents to indicate whether they routinely provided a
 cardiac rehabilitation service for patients with heart failure and to
 identify and give brief details about barriers to provision of such a
 service. The stage 1 questionnaire was mailed out by the NACR office in
 York (A copy of the stage 1 questionnaire is included as an appendix to
 the main paper ).Cardiac Rehab in HF
 Stage 2 SurveyStage 2 of the survey
 was sent from the Royal Cornwall Hospitals Trust and included all centres
 that confirmed in stage 1 that they provided a separate cardiac
 rehabilitation service for patients with heart failure. These centres were
 sent a 44 item, five page questionnaire designed to find out more about
 the nature (patient demographics and staffing) and content of their
 cardiac rehabilitation service (see appendix of the main paper for a copy
 of the stage 2 questionnaire). In the first instance, the stage 2
 questionnaire was sent by email, with a letter explaining why more
 detailed information was being requested from the centres. To optimise
 response rates, non-responders were sent personalised letters with stamped
 addressed envelopes, and these were followed by reminder emails and
 telephone callsNACR Database Stage 1
 ComparisonDataTo validate the data,
 responses from stage 1 in terms of the demographic and activity features
 of the centres were compared with information from the NACR (the methods
 and measures used by the NACR are described on and available for download
 from www.cardiacrehabilitation.org.uk/nacr).