Objectives: There is robust clinical evidence demonstrating the benefits of cardiac rehabilitation (CR) for patients with ischaemic heart disease1. It is known that survivors of TIA and stroke have the same modifiable risk factors as those with cardiovascular disease2 and emerging international research shows that application of the cardiac rehabilitation paradigm is both feasible and effective as a means of secondary prevention for this population. In Ireland, CR is routinely offered to all patients with IHD but access for patients post stroke and TIA is limited. The purpose of this study was to determine the availability of CR for patients post-stroke and TIA and barriers to same.
Methods: A survey was created and distributed to all facilities offering CR programmes in Ireland, to determine access for patients with TIA and stroke and identify barriers to their inclusion.
Results: Nineteen of the 36 Irish CR facilities (53%) replied to our survey. Of these, three enrolled patients with a primary diagnosis of TIA and two enrolled patients with a primary diagnosis of stroke. Only one facility had a stroke/TIA specific CR.
Barriers to the enrolement of individuals with stroke onto the programmes included lack of resources and staffing, over-capacity of CR programmes, lack of expertise of staff, different psychological, communication and cognitive issues of this population; and the lack of a referral pathway for these patients.
Conclusion: Despite evidence supporting the provision of CR for patients post stroke and TIA, access to these programmes in Ireland remains largely unavailable.
References:
1. Taylor R.S. et al. (2004) Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. American Journal of Medicine, May:15:116(10):682-9
2. Kernan W.N et al. (2014) Guidelines for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack. Stroke. 47 (10), 1-15.
