Investigation is needed into why some patients are not offered cardiac rehabilitation

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7067.1264a (Published 16 November 1996) Cite this as: BMJ 1996;313:1264
  1. Darren Greenwood,
  2. Christopher Packham,
  3. Kenneth Muir,
  4. Richard Madeley
  1. Medical statistician MRC Institute of Hearing Research, Nottingham NG7 2RD
  2. Senior lecturer in public health Lecturer in epidemiology Director of School of Public Health Department of Public Health Medicine and Epidemiology, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH

    EDITOR,—Jill Pell and colleagues report the influence of social deprivation on the uptake of cardiac rehabilitation.1 Through their study the authors have identified an important area of research that could eventually lead to improvements in rehabilitation for deprived patients. In 1995 we reported that economically disadvantaged patients showed poorer survival than others after myocardial infarction,2 and Pell and colleagues' study suggests a possible mechanism for this: that fewer deprived patients take up and complete rehabilitation programmes.

    We note that the type of consultant and the hospital attended were also associated with uptake of rehabilitation. Just as striking is that the invitation to take up rehabilitation also depended on the consultant and hospital attended. In addition to carrying out research into why deprived patients are less likely to complete rehabilitation we clearly need to ask ourselves why some patients are not invited in the first place. The sizes of the effects suggest that the potential for improvement lies as much with the medical community as with the patients.


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