Research presented at the 29th Great Wall International Congress of Cardiology (GW-ICC) meeting (11–14 October, Beijing, China) shows that just one-third of patients in China with acute coronary syndromes, including myocardial infarction, receive cardiac rehabilitation guidance before discharge from hospital. Furthermore, only one in 10 receive personalised advice.
A study examined the proportion of patients in China with acute coronary syndromes including myocardial infarction and unstable angina who received cardiac rehabilitation guidance before discharge from hospital. It was conducted within the Improving Care for Cardiovascular Disease in China – Acute Coronary Syndrome (CCC-ACS) project—a nationwide registry and quality improvement programme of the Chinese Society of Cardiology and American Heart Association.
After excluding patients with incomplete demographic information (191) and those who died during hospitalisation (1,223), the study enrolled 62,227 patients with acute coronary syndromes from 150 hospitals across China between November 2014 and June 2017. Cardiac rehabilitation guidance was defined as providing a health brochure or personalised rehabilitation plan.
Just one-third (32.8%) of patients received guidance before discharge, and only one in 10 (9.7%) were given an individualised plan. Men were more likely to receive advice (33.6%) than women (30.6%). The rate of guidance provision declined with increasing age, with 34% of under 45s receiving advice, compared with 32.9% of 45–74 year-olds, and 31.9% of those aged 75 years and above.
Furthermore, patients with a history of coronary heart disease received advice less often (30.5%) than those with no history (33.1%). However, patients who had a stent implanted after their myocardial infarction received advice more often (35.1%) than those who did not get a stent (27.5%).
Study author Guoliang Hu (Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China), says: “Prior research has suggested that women and older patients may benefit most from rehabilitation. In our study, these groups were even less likely to receive advice and, therefore, targeted efforts are needed. All myocardial infarction patients need cardiac rehabilitation and talking to them before discharge is an effective way to encourage participation, but this is an emerging field in China. The first step towards improving provision is to increase clinician awareness about the benefits of discussing cardiac rehabilitation before patients go home, just as they prescribe discharge medications. China also needs a cardiac rehabilitation referral system, evidence-based programmes, and dedicated centres and teams.”