Twice Shy

Why heart attack survivors need to take back control of their health

Cardiac disease, or CVD, is the leading cause of death and disease globally. Here in Australia, 65,000 people experience a heart attack or unstable angina every year - but many of these are preventable.

Professor Julie Redfern, director of Bond University's Institute for Evidence-Based Healthcare, leads SOLVE-CHD, a research program aimed at transforming cardiac rehabilitation in Australia and overseas. They're on a mission to ensure survivors get better healthcare access and advice to prevent them from having a second heart attack.

A growing need

'With new surgeries and medicines, we're seeing more people surviving heart attacks, meaning more people living with ongoing management of heart disease,' says Professor Redfern.

'But this area of healthcare has been frozen since the 1960s. With cardiac surgery and medicines becoming the focus, rehabilitation hasn't been getting the funding and recognition it deserves.

'Traditional cardiac rehabilitation involved a six-to-eight-week program

aimed at helping patients get back on track. However, only around 30 per cent of survivors participated in the program and those that did had difficulty sustaining their progress ongoing.

'We're trying to offer something better for these people by modernising the rehabilitation component across Australia and collaborating with international bodies to extend the knowledge and learnings globally.'

Uniting the experts

Professor Redfern led and convened the Global Cardiac Prevention and Rehabilitation Forum in London in August to mobilise and unite members of the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR).

'We brought together over 50 experts from 42 organisations and associations at the forum, representing all World Health Organisation regions to tackle this problem and move this area into the 21st century,' explains Professor Redfern.

'One of the key points outlined by the forum is the need to drive cardiac rehabilitation forward in terms of what it is and how we can better understand the data and messaging around it.'

Keeping it simple

Driving global change is not without significant challenges. At the London forum, Professor Redfern recalls the disparity in programs across regions.

'At my table, we had a representative from Malawi who is fighting for the first cardiac rehabilitation program to ever be introduced in her country,' she says.

'In contrast, sitting next to her was a participant from Austria, where an incredible month-long, live-in rehabilitation program is available that provides everything from meals to psychologists and activities. There is real disparity in capabilities, policies and workforce between countries and it's a huge problem.

'The way forward is simplicity. Finding core messaging and shared data that can be used to advocate for cardiac rehabilitation policies nationally and internationally.'

A lifelong arrangement

The increased risk of further heart attacks for survivors means they need to be proactive about cardiac health for the rest of their lives. Professor Redfern refers to it as a 'lifelong arrangement'.

'When you have a heart attack, you can still look and feel the same as you did before. It's not like other illnesses and treatments, where you can look and feel poorly,' she says.

'You might get a stent put in. You go home that same afternoon. But you must do things that will reduce your risk going forward, otherwise you could have another heart attack.

"We're trying to give survivors access to better information about where quality programs are - delivering more choice and driving up quality of care as a result.'

Tried and tested

Professor Redfern, who teaches into Bond's Master of Healthcare Innovations, is modelling her vision for an Australian-wide cardiac

rehabilitation program on Britain's quality 'traffic light' system.

'Survivors can search for cardiac rehabilitation programs near them and see the benchmarks for quality. This approach has improved the quality of programs in the United Kingdom by 30 per cent,' she says.

'We'd like to set up a similar system here in Australia within the next two years, so patients can see the quality of programs near them and exert more choice and control over their rehabilitation.

'We'll start here in Queensland and roll it out nationwide. The data from the Australian implementation could then be used for other countries to advocate for a similar healthcare policy.'

A common vision

Professor Redfern and her team are on a mission to unite cardiac rehabilitation experts worldwide through their high-impact research.

'We've created a common vision for everyone in Australia to work towards and are on track to achieve it,' she says.

'The next step is working towards finding that common vision on an international level.'