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Published on February 05, 2018

Had a heart attack? Are you in rehab?

Approximately, 935,000 adults in the United States have a heart attack each year and over 30 percent of those will have another attack that can potentially be fatal, according to the American Heart Association (AHA).

While studies have shown the benefits of cardiac rehabilitation following a heart attack, it remains under-utilized. A recent study published by the Centers for Disease Control and Prevention indicated that only one in three heart attack survivors participated in cardiac rehab after suffering a heart attack.

A 2013 study of 20 states and the District of Columbia showed 33.7 percent of post-heart attack adults participated in a cardiac rehab program. It wasn’t much better two years later when a review of four states indicated it had only increased to 35.5 percent.

“There is still a lack of awareness of the benefits of cardiac rehabilitation,” said John Guerin, MD, FACC, Falmouth Hospital’s medical director of cardiac rehabilitation. “In the past, it was just a nice thing to do and people did well with it. Most of them were motivated and therefore would do well no matter what they did.

Cape Cod Healthcare has two cardiac rehab facilities. In addition to the FH program, there is a program near Cape Cod Hospital in Hyannis at 25 Main Street.

“All of our cardiologists at Cape Cod and Falmouth hospitals encourage their patients to do cardiac rehab,” said Dr. Guerin.

According to the AHA, cardiac rehabilitation reduces mortality by 50 percent compared to those who do not participate in a program. Dr. Guerin explained there are several studies that have proven that when people go through the cardiac rehab programs, they do better in the long run.

While it increases their life expectancy, “there is also a reduction in the emotional and physical problems that a lot of heart attack survivors experience,” he said.

Reasons for Non-Participation

The AHA lists the following reasons why heart attack patients do not participate in a cardiac rehab program:

  • Lack of referral or a strong endorsement from the patient’s physician
  • Limited or no health insurance
  • Conflicts with work or home responsibilities
  • Lack of program availability and access

Insurance coverage and high copays have recently become a barrier for patients.

“Several people who have been referred to the program, started it and then had to drop out because they are paying a copay every time they come to rehab, which is three times a week for 13 weeks. Some have copays of $50 and at $150 per week, its cost prohibitive,” Dr. Guerin said.

Susan Crider, RN, BSN, clinical coordinator of the Falmouth Hospital Cardiac Rehabilitation department, is working with patients to move them more quickly into the maintenance program. They are still monitored in the same way as the rehab program, but the cost is significantly less at $63 per month.

Dr. Guerin estimates that 80-90 percent of the patients who start the Falmouth Hospital’s cardiac rehabilitation program complete it. Some who do not finish or can’t participate may have difficult ailments such as rheumatoid arthritis or major hip/knee problems that prevent them from using the equipment.