From the Guidelines
Cardiac rehabilitation in the Australian health system is based on a comprehensive program that includes attendance at cardiac rehabilitation or a structured secondary prevention service for all patients hospitalized with acute coronary syndrome (ACS), with individualization of cardiac rehabilitation or secondary prevention service referral, as recommended by the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand 1. The program is designed to improve cardiovascular outcomes and reduce morbidity and mortality.
- The key components of the program include:
- Physical activity adapted to the clinical condition and ability of the patient
- Lifestyle advice, including advice on driving, flying, and sexual activity
- Stress management
- Health education
- The program is typically provided in a format and setting that is easily accessible for the patient, including hospital, primary care, community, or home-based settings.
- The multidisciplinary team involved in the program includes cardiologists, nurses, physiotherapists, exercise physiologists, dietitians, and psychologists.
- The goal of the program is to improve physical functioning, quality of life, and reduce hospitalizations, particularly in patients with stable chronic heart failure (HF) and reduced left ventricular ejection fraction (LVEF) 1.
- Regular performance of moderate-intensity continuous exercise is recommended for patients with stable chronic HF to improve physical functioning and quality of life, and to reduce hospitalizations 1.
From the Research
Cardiac Rehabilitation Program in the Australian Health System
The cardiac rehabilitation program used in the Australian health system is a comprehensive multidisciplinary program aimed at preventing repeat acute coronary syndrome (ACS) by supporting patients' return to an active and fulfilling lifestyle 2. The program's core components include:
- Interventions to lower blood pressure and improve lipid and diabetes mellitus control
- Tobacco cessation and behavioral counseling
- Graded physical activity, typically involving 36 sessions over 12 weeks
- Counseling on nutrition, screening for and managing depression, and assuring up-to-date immunizations 3
Key Features of the Program
Some key features of the cardiac rehabilitation program in Australia include:
- A multidisciplinary approach, with a team of healthcare professionals working together to support patients
- A focus on improving daily function and reducing cardiovascular risk factors
- The use of quality indicators to measure program performance and adherence to best practices 2
- The availability of alternative programs, such as home-based and telephone-based programs, to improve accessibility for patients in rural and remote areas 4, 5
Challenges and Limitations
Despite the benefits of cardiac rehabilitation, there are challenges and limitations to the program, including:
- Variability in program delivery and adherence to quality indicators 2
- Low referral rates and poor access to programs, particularly in rural and remote areas 4
- Limited availability of programs and services, particularly for certain patient groups, such as older adults and those living in areas where cardiac rehabilitation is not locally available 3
- The need for improved models of referral and access, greater flexibility of programs, and increased education and involvement of patients and healthcare professionals 4