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Aims of the British Association for Cardiovascular Prevention and Rehabilitation standards and core components
This second edition of the Standards and Core Components (SCC) for Cardiovascular Disease Prevention and Rehabilitation from the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) define cardiac rehabilitation (CR), operationally, through seven standards and seven core components for assuring a quality service of care using a multidisciplinary biopsychosocial approach.1 The seven standards aim to ensure that service commissioners, providers and health professionals are aware of the requirements for providing a multidisciplinary CR team that is competent and thus clinically effective, cost-effective and ultimately cost-saving as a result of preventing hospital readmissions. The seven core components (figure 1), delivered as a coordinated sum of activities aim to best influence uptake, adherence, quality of life and long-term healthier living.2 Details of the full version and related evidence base of the BACPR SCCs can be accessed from the following website: http://www.bacpr.com
Current challenges to implementing the evidence and achieving quality outcomes
Over the past three decades overwhelming evidence on comprehensive CR, which includes exercise, has reported reductions in morbidity and mortality; re-infarctions (47%), cardiac mortality (26–36%) and total mortality (13–26%).3 ,4 Secondary prevention, including blood pressure and cholesterol management and the prescription of cardioprotective medication, now also forms an integral part of an effective CR programme.5 The current evidence base included under the ‘umbrella’ of CR has reported many variations in the ‘dose’ of individual or collective interventions (medical, lifestyle and psychosocial), which may therefore explain the variations of outcomes found in the studies included in the key systematic reviews on CR.3 ,4 More recently published British evidence clearly shows that when the ‘dose’, at least of the exercise component, of CR is below those found in the more ideal research studies, the outcomes (functional …
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