{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:25:01Z","timestamp":1788992701516,"version":"build-2803163510"},"reference-count":25,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2016,1,8]]},"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To ascertain the characteristics associated with delayed cardiac rehabilitation (CR) and determine if an association between CR timing and fitness outcomes exists in patients receiving routine care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The study used data from the UK National Audit of Cardiac Rehabilitation, a data set which captures information on routine CR practice and patient outcomes. Data from 1 January 2012 to 8 September 2015 were included. Logistic regression models were used to explore the relationship between timing of CR and fitness-related outcomes as measured by patient-reported exercise level (150\u2005min\/week: yes\/no), Dartmouth quality of life physical fitness scale and the incremental shuttle-walk test.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Based on UK data current CR practice shows that programmes do not always adhere to recommendations on the start of prompt CR, that is, start CR within 28\u2005days of referral (42\u2005days for coronary artery bypass graft (CABG)). Wait time exceeded recommendations in postmyocardial infarction (post-MI), elective percutaneous coronary intervention (PCI), MI-PCI and post-CABG surgery patients. This was particularly pronounced in the medically managed post-MI group, median wait time 40\u2005days. Furthermore, statistical analysis revealed that delayed CR significantly impacts fitness outcomes. For every 1-day increase in CR wait time, patients were 1% less likely to improve across all fitness-related measures (p&lt;0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>With the potential for suboptimal patient outcome if starting CR is delayed, efforts should be made to identify and overcome barriers to timely CR provision.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2015-000369","type":"journal-article","created":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T22:50:39Z","timestamp":1454971839000},"page":"e000369","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":58,"title":["Does the timing of cardiac rehabilitation impact fitness outcomes? An observational analysis"],"prefix":"10.1136","volume":"3","author":[{"given":"Jennifer","family":"Fell","sequence":"first","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Dale","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Doherty","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,2,8]]},"reference":[{"key":"2025081612005990000_3.1.e000369.1","unstructured":"World Health Organisation. Cardiovascular diseases factsheet 317. WHO, 2015."},{"key":"2025081612005990000_3.1.e000369.2","unstructured":"Centre for Economics and Business Research. The economic cost of cardiovascular disease from 2014\u20132020 in six European economies. London: CEBR, 2014."},{"key":"2025081612005990000_3.1.e000369.3","unstructured":"NICE. MI-secondary prevention guideline 172. UK: NICE, 2013."},{"key":"2025081612005990000_3.1.e000369.4","doi-asserted-by":"crossref","unstructured":"Heran BS , Chen JM , Ebrahim S , et al . Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2011;(7):CD001800.","DOI":"10.1002\/14651858.CD001800.pub2"},{"key":"2025081612005990000_3.1.e000369.5","doi-asserted-by":"publisher","DOI":"10.1177\/2047487312449597"},{"key":"2025081612005990000_3.1.e000369.6","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcm020"},{"key":"2025081612005990000_3.1.e000369.7","unstructured":"The National Audit of Cardiac Rehabilitation (NACR). Annual Statistical Report. UK: NACR, 2014."},{"key":"2025081612005990000_3.1.e000369.8","unstructured":"BACPR. The BACPR standards and core components for cardiovascular disease prevention and rehabilitation. UK: BACPR, 2012."},{"key":"2025081612005990000_3.1.e000369.9","unstructured":"Department of Health. Service specification for cardiac rehabilitation services. UK: DoH, 2010."},{"key":"2025081612005990000_3.1.e000369.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.09.036"},{"key":"2025081612005990000_3.1.e000369.11","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.121996"},{"key":"2025081612005990000_3.1.e000369.12","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e318228a32f"},{"key":"2025081612005990000_3.1.e000369.13","unstructured":"NICE. Cardiac rehabilitation services commissioning guide 40. UK: NICE, 2011."},{"key":"2025081612005990000_3.1.e000369.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"issue":"5 Suppl","key":"2025081612005990000_3.1.e000369.15","first-page":"Ms42","article-title":"Benefits and obstacles of health status assessment in ambulatory settings. The clinician's point of view. The Dartmouth Primary Care COOP Project","volume":"30","author":"Wasson","year":"1992","journal-title":"Med Care"},{"key":"2025081612005990000_3.1.e000369.16","doi-asserted-by":"publisher","DOI":"10.1177\/2047487314540840"},{"key":"2025081612005990000_3.1.e000369.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.11.040"},{"key":"2025081612005990000_3.1.e000369.18","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.891523"},{"key":"2025081612005990000_3.1.e000369.19","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313486040"},{"key":"2025081612005990000_3.1.e000369.20","doi-asserted-by":"publisher","DOI":"10.1097\/HCR.0b013e3181be7e32"},{"key":"2025081612005990000_3.1.e000369.21","doi-asserted-by":"publisher","DOI":"10.1310\/ETDP-6DR4-D617-VMVF"},{"key":"2025081612005990000_3.1.e000369.22","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-45"},{"key":"2025081612005990000_3.1.e000369.23","doi-asserted-by":"publisher","DOI":"10.1177\/1741826711425427"},{"key":"2025081612005990000_3.1.e000369.24","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-012-2302-x"},{"key":"2025081612005990000_3.1.e000369.25","doi-asserted-by":"publisher","DOI":"10.1186\/1745-6215-12-92"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2015-000369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T19:01:09Z","timestamp":1755370869000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2015-000369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,8]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,2,8]]},"published-print":{"date-parts":[[2016,8]]}},"alternative-id":["10.1136\/openhrt-2015-000369"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2015-000369","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,8]]}}}