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Journal of Public Health Advance Access originally published online on October 26, 2005
Journal of Public Health 2006 28(1):35-38; doi:10.1093/pubmed/fdi064
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© The Author 2005, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.

NSF for CHD: 3 years of 12-month follow-up audit after cardiac rehabilitation



Julia A. Evans

Hugh J. N. Bethell

Sally C. Turner
Julia A. Evans, PhD, Researcher in Cardiac Rehabilitation, Hugh J. N. Bethell, MD FRCP FRCGP, Research Director, Sally C. Turner, MSc, Head Of Department, Basingstoke and Alton Cardiac Rehabilitation Centre, Chawton Park Alton, Hampshire, GU 34 IRQ, UK

Address correspondence to Julia A. Evans. Email: julia{at}cardiac-rehab.co.uk

Background The coronary heart disease (CHD) National Service Framework (NSF) sets standards and milestones. For acute myocardial infarction (AMI) or coronary revascularization, ‘Milestone 3, of Standard 12 requires that, by April 2002, every hospital should have clinical audit data no more than 12 months old showing ‘total number and % of those recruited to cardiac rehabilitation who, one year after discharge, report: regular physical activity of at least 30 minutes duration on average five times a week, not smoking and a Body Mass Index (BMI) of <30 kg/m2’. This study looked at cost, method and practicalities of retrieving this data.

Methods A postal questionnaire was used to follow-up coronary patients who started our cardiac rehabilitation programme between 1 April 2001 and 31 March 2004. The project was costed.

Results Three hundred and seventy-five (33 per cent) AMI patients, 412 (36 per cent) coronary artery bypass grafting (CABG) patients and 343 (30 per cent) percutaneous coronary intervention (PCI) patients entered the cardiac rehabilitation programme over 3 years. Completed questionnaires were received from 903 (80 per cent). Post-AMI patients or those stratified as high risk for further cardiac events were least likely to respond. Of responders, 74 per cent were exercising regularly, 95 per cent were not smoking and 79 per cent had a BMI <30 kg/m2.

Conclusion Targets for smoking and BMI set by the NSF are too low and were achieved by most patients before the start of cardiac rehabilitation. Patients who are post-AMI or are stratified as high risk need to be targeted if a high level of follow-up is to be achieved.

Keywords: cardiac rehabilitation, exercise, NSF, smoking


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