The Participation of Patients with Chronic Heart Failure in Comprehensive Cardiac Rehabilitation: A Literature Review

Introduction: Cardiac rehabilitation (CR) is a well-documented, evidence based course of long term management for patients with chronic heart failure (CHF) whose participation in comprehensive rehabilitation is accompanied by excellent outcomes. Aim: To review the Greek and international literature relevant to the content of comprehensive CR for patients with CHF. Method: A search was made of the electronic databases Medline and Google Scholar in December 2013 using the key-words: “cardiac rehabilitation”, “chronic heart failure”, “exercise”, “heart failure”, “outcomes”, “patient education”, “self-care interventions”, in conjunction with the corresponding Greek words or phrases. Articles were studied which were published from 2000 to 2013 in the English and/or Greek language investigating or reviewing the participation of CHF patients in CR programmes and the programme content. Results: The core components of comprehensive CR for patients with CHF are exercise, education, counselling and psychosocial support, services which were provided using a multidisciplinary approach and cooperation. The necessity of participation of patients with CHF in CR is determined by the epidemiological characteristics of CHF, the documented benefit for both the patients and the healthcare system and the poor self-care behaviour of these patients, which is modifiable though the use of rehabilitation services. Although the resulting benefit is undeniable, the participation of patients with CHF in CR is extremely low worldwide. Conclusions: CR is useful, safe and effective and it is necessary for patients suffering from CHF. New models of healthcare delivery with adequate healthcare infrastructure and qualified staff, in conjunction with further research to provide strong evidence of the benefits of rehabilitation, could result in the incorporation comprehensive CR into CHF therapeutic management programmes.