The National Service Framework: six years on

Swanton, Ruth

doi:10.1136/hrt.2005.066043

Cited by 8 publications

(4 citation statements)

References 2 publications

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“…The number of cardiac rehabilitation programmes has increased rapidly over the past decade 24 but there is still a substantial gap between programmes with regard to referral rates 7,10,25,26 and drop-out rates. 25,27 In our study early drop-out from cardiac rehabilitation is predicted by younger age, female gender, psychological distress related to heart problems, a perception that illness has less severe consequences and a perception that power of personal control is high or that treatment control is poor.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the documented evidence and professional societies' promotion of the benefits of cardiac rehabilitation 1 Á 5 in enhancing physical activity, psychological well-being and quality of life in patients with cardiac problems, this service has consistently been underutilized. 6,7 A significant proportion of patients fail to attend rehabilitation sessions or drop out prematurely. Participation rates in cardiac rehabilitation have been reported as being between 21% and 41%.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of drop-out from an outpatient cardiac rehabilitation programme

et al. 2007

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Over a fifth of the patients did not complete this typical cardiac rehabilitation programme. Female patients are more likely to drop out from cardiac rehabilitation than men. Psychological distress, younger age and lower perceptions of consequences, higher perception personal control and lower illness perception of treatment control were predictors of early drop-out from a cardiac rehabilitation programme.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of drop-out from an outpatient cardiac rehabilitation programme

et al. 2007

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“…18 The story of statin development will always be seen as a great success, both scientifically and financially, with statin prescriptions costing around £0.6 billion in the UK and more than $12 billion in the US in 2005 and costs increasing annually. 19 It illustrates how epidemiological data can provide the evidence for theories on disease processes, which can in turn lead to the development of targeted therapies to modify these The internationally distinguished speakers assembled for this Hot Topic Symposium, organised by the Royal College of Physicians of Edinburgh, will address the issues of healthcare-associated infections as they affect medical and paramedical practitioners, and describe the current and likely future size of the problem along with possible solutions.…”

Section: Resultsmentioning

confidence: 99%

Statins: in the beginning

Lyons

Harbinson

2009

JRCPE

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“…76 There appears to be a chronic understaffing in this area, with only 1 in 4 centres having purpose-built facilities and half do not hold their budgets. 77 Historically, cardiac rehabilitation classes have been held in hospitals. Community centre or homebased rehabilitation programmes appear to be safe and effective, and may improve access to cardiac rehabilitation.…”

Section: Cardiac Rehabilitationmentioning

confidence: 99%

Recent developments in acute coronary syndromes

2008

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-Coronary artery disease is the leading cause of death in the UK with a high clinical, social and economic burden. The management of acute coronary syndromes is rapidly evolving and clinicians are constantly challenged with incorporating new clinical pathways and guidelines into their practices. It is important for clinicians to have a sound working knowledge of acute coronary syndromes, and be updated on the emerging evidence to guide therapy and improve outcomes in these patients.KEY WORDS: acute coronary syndromes, coronary artery disease, myocardial infarction IntroductionOver recent years, there has been overwhelming trial data, which has had significant impact on our management of patients with acute coronary syndromes. There is greater emphasis on earlier reperfusion with different strategies in acute myocardial infarction (MI), development and greater use of novel antithrombotic agents, and greater emphasis on secondary prevention and cardiac rehabilitation. This review article serves to update physicians both in the primary and secondary care setting in this rapidly evolving field of acute coronary syndromes. Sources and selection criteriaA literature search was conducted using PubMed/ Medline, EMBASE and Cochrane databases using coronary artery disease (CAD), acute coronary syndromes and MI as keywords. References of recent major articles and key reviews were also researched, and articles were accessed where necessary. ClassificationAcute coronary syndromes include unstable angina (USA), non-ST segment elevation MI (NSTEMI) and ST segment elevation MI (STEMI). Acute coronary syndromes with persistent STEMI generally require urgent reperfusion therapy. Those without persistent ST-elevation represent a continuum from USA to NSTEMI and can be further classified on the basis of troponin release, a biochemical marker of myocardial cell death (Fig 1). EpidemiologyAn estimated 2.7 million people in the UK have CAD which accounts for over 105,000 deaths per year. Approximately 1.3 million people in the UK have had a MI, 2 million people suffer from angina, and over 230,000 new MIs are diagnosed every year. 1 Over the last decade, the proportion of patients presenting with STEMI has fallen, while there has been an increase in USA and NSTEMI. 2 Explanations for this apparent change are probably multifactorial, but relate to advances in therapy, risk factor reduction, better primary and secondary preventative strategies and appropriate coronary revascularisation. In addition, the growing use of troponin assays, which have an increased overall diagnostic sensitivity for MI, has facilitated more effective early treatment. Reperfusion therapy in STEMI ThrombolysisFor over two decades, thrombolysis has been the cornerstone in the acute management of STEMI, s ORIGINAL PAPERS 42

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The National Service Framework: six years on

Cited by 8 publications

References 2 publications

Predictors of drop-out from an outpatient cardiac rehabilitation programme

Predictors of drop-out from an outpatient cardiac rehabilitation programme

Statins: in the beginning

Recent developments in acute coronary syndromes

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