Medical study sings praises of cardiac program
Healthy Hearts being dropped at London hospital despite success elsewhere
Turns out you don’t have to go far to unravel the claims made by those planning to close London’s Cardiac Fitness Institute.
You only have to go to nearby Goderich, where a program inspired by that in London is thriving, its success shown in a recent study.
“(The London cardiac rehab program) should be placed on a pedestal instead of being torn down,” the study’s lead author, Kent Gillen, said.
Published in 2016 in the peerreviewed Canadian Journal of Rural Medicine, the study found that patients who stay in the Goderich program, called Healthy Hearts, improve long after Ontario cuts off rehab funding at six months, and that the benefits are maintained for nine years.
Nearly a decade after they start cardiac rehab, patients push themselves on a treadmill for 35 per cent longer than they could when they began, efforts that also stabilize blood pressure and resting heart rate.
The benefits weren’t just physical, but emotional and social as well, Gillen said.
The lesson from the research is clear, Gillen told the Canadian Cardiovascular Congress at its annual gathering two years ago — don’t kick out cardiac rehab patients after six weeks or six months, the latter the model adopted by Ontario’s Health Ministry.
“We said don’t do that. Keep them in as long as you can.” The living testament of his advice is Bill Anderson, a Second World War veteran who turns 96 on Tuesday. Anderson suffered his first heart attack about 1990, then had a second several years later. But after 21 years in the Goderich program, he’s healthy enough to celebrate his birthday this month by travelling to northern Ontario with three people half his age to do some fly fishing.
As an academic health sciences centre, LHSC adheres to evidence-based decision making when it comes to how patient care is delivered.
“It gave me discipline, routine, supervision and medical oversight,” Anderson said of the program. “If it were not for Healthy Hearts, I’d probably not be here.” LHSC plans to phase out the cardiac program starting this month over the objections of patients and lead doctor Larry Patrick, who point out the program typically has cost the hospital not more than $300,000 from a hospital budget of about $1.2 billion.
LHSC officials have defended the closing, which triggered a wave of angry calls and emails by patients to Postmedia News, by claiming the best and most recent medical evidence supports a six-month program.
The Cardiac Fitness Institute had provided exercise, stress testing and counselling to cardiac patients for as long as they wanted. In ending the program, LHSC has noted the institute doesn’t fall under the mandate of an acutecare hospital, and that the hospital “receives no funding to support similar services and can no longer subsidize” CFI program costs. The chief executive of the London Health Sciences Centre, Dr. Paul Woods, has declined to be interviewed about LHSC’s decision to close the cardiac rehab program that first opened in 1981. Instead, the hospital posed its own questions and answers on its website. “Why are you closing the program? As an academic health sciences centre, LHSC adheres to evidence-based decision making when it comes to how patient care is delivered. The decision to wind down the Cardiac Fitness Institute is an outcome of that approach,” hospital officials wrote.
But while London hospital officials claim they made a decision based on evidence and wrote more than 2,000 words defending their decision, the only “evidence” they link is a report on cardiac rehab in Ontario that does not recommend any time frame for rehabilitation. London officials don’t mention the Goderich study, or one published in June in the peerreviewed journal of the British Cardiovascular Society that found that those in cardio rehab for more than three years were 60 per cent more likely to be alive 14 years later than those whose rehab ended after one year.