Cardiac rehab physios need to have honest conversations with people with heart failure, says NICE

Cardiac rehab physiotherapists, and other clinicians who work with people with heart failure, need advanced communication skills and could benefit from extra training.

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NICE recommends personalised, exercise-based cardiac rehab programmes

This is according to an updated guideline on the diagnosis and management of chronic heart failure, published by the National Institute for Health and Care Excellence (NICE) on 12 September.

It suggests that healthcare professionals need to be able have honest, open and sensitive discussions with patients, which explain the uncertainty of predicting the course of their prognosis.

Laura Burgess, co-chair of the Association of Chartered Physiotherapists in Cardiac Rehabilitation (ACPICR), told Frontline: ‘Cardiac rehabilitation requires comprehensive assessment sessions, followed by a course of education and exercise sessions. This offers physiotherapists the opportunity to have time to get to know their patients very well and to build a good rapport to be able to have that honest conversation.

‘With their extensive clinical experience during and post-training physiotherapists are well placed to be able to fulfil this requirement.

‘The British Association for Cardiovascular Prevention and Rehabilitation [BACPR] have a two day course called “Health Behaviour Change and Psychosocial Support” which is also a very valuable resource cardiac rehab physios should access.’

Exercise-based rehab

The guideline also reiterates that people with heart failure should have access to personalised, exercise-based cardiac rehabilitation programmes. But in updated advice, it suggests that people with heart failure should receive information about what support is available from healthcare professionals while they are completing their rehab programme.

Other updates include that multidisciplinary teams that specialise in heart failure should:

  • write a summary for each person with heart failure that includes social circumstances, including carers' needs
  • directly refer people with heart failure to other relevant services, such as older people and palliative care services or rehab services, as needed
  • manage heart failure that is not responding to treatment.

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by Robert Millett

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