British Heart Foundation

   British Heart Foundation (BHF) National Audit of Cardiac Rehabilitation

NHS Digital



Recent research outputs for the Cardiovascular Health Research Group (2012-)

Factors influencing change in walking ability in patients with heart failure undergoing exercise-based cardiac rehabilitation
Natasha Sutherland, Alexander Harrison, Patrick Doherty

Does the mode of delivery in Cardiac Rehabilitation determine the extent of psychosocial health outcomes?
AS Harrison and PJ Doherty
International Journal of Cardiology 255 (2018) 136-139

Overview of Cardiac Rehabilitation Evidence, Benefits and Utilisation
Al Quait, A. I. M. & Doherty, P. J.
19 Dec 2017 Article in: Global Journal of Health Science. 10, 2, p. 38-48

An analysis of barriers to entry of cardiac rehabilitation in patients with diabetes: Using data from the National Audit of Cardiac Rehabilitation
Harrison, A. S., Doherty, P. & Phillips, A.
5 Dec 2017 Article in: Diabetes & vascular disease research.

Does service timing matter for psychological outcomes in cardiac rehabilitation?: Insights from the National Audit of Cardiac Rehabilitation
Sumner, J., Böhnke, J. R. & Doherty, P.
9 Nov 2017 Article in : European Journal of Preventive Cardiology. 10 p.,

Cardiac rehabilitation: making a business case based on the evidence
Gore, L. & Doherty, P. J.
11 Oct 2017 Article in: British Journal of Cardiac Nursing. 12, 10

The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology.
Hansen D, Dendale P Coninx K, Vanhees L, Piepoli MF, Niebauer J, Cornelissen V, Pedretti R, Geurts E, Ruiz GR, Corrà U, Schmid JP Greco E, Davos CH, Edelmann F Abreu A, Rauch B, Ambrosetti M, Braga SS, Barna O, Beckers P, Bussotti M, Fagard R, Faggiano P, Garcia-Porrero E, Kouidi E, Lamotte M, Neunhäuserer D6, Reibis R, Spruit MA, Stettler C, Takken T, Tonoli C, Vigorito C34, Völler H,36, Doherty P
7 Aug 2017 Article in: European Heart Journal. 38, p. 2318-2324

Cardiac rehabilitation in heart failure with reduced ejection fraction: A "should take it and not leave it" intervention
Taylor, R., Dalal, H. M., Davies, R., Doherty, P. J., Jolly, K., Lang, C. & Wingham, J.
18 Jul 2017 Letter in: American Heart Journal.

Do the demographic characteristics and baseline health state of patients vary in different cardiac rehabilitation performance programmes?
A. Salman P. Doherty
European Heart Journal, Volume 38, Issue suppl_1, 1 August 2017, ehx502.P2498.

In the modern era of percutaneous coronary intervention: Is cardiac rehabilitation engagement purely a patient or a service level decision?
Al Quait, A. I. M., Doherty, P. J., Gutacker, N. & Mills, J. 21 Jun 2017
Article in European Journal of Preventive Cardiology

Characteristics of structured physical training currently provided in cardiac patients: insights from the Exercise Training in Cardiac Rehabilitation (ETCR) Italian survey
Ambrosetti, M., Doherty, P. J., Faggiano, P., Corrà, U., Vigorito, C., Hansen, D., Sarto, P., Abreu, A. & Pedretti, R. F. E. 18 May 2017
Article in Monaldi Archives for Chest Disease

The effectiveness of modern cardiac rehabilitation: A systematic review of recent observational studies in non-attenders versus attenders
Sumner, J., Harrison, A. & Doherty, P. 12 May 2017
Article in PloS One

The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology
Doherty, P. & 35 others 18 Apr 2017
Article in European journal of preventive cardiology

Evaluation of determinants of walking fitness in patients attending cardiac rehabilitation
Alotaibi, J. F. M. & Doherty, P. J. 1 Mar 2017
Article in BMJ Open Sport & Exercise Medicine

Doherty P, Salman A, Furze G, Dalal H, Harrison A. Does cardiac rehabilitation meet minimum standards: an observational study using UK national audit? Open Heart 2017;4:e000519. doi:10.1136/openhrt-2016-000519

Tang L, Berg SK, Christensen J, Lawaetz J, Doherty P, Taylor RS, Langberg H, Zwisler AD. Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation International Journal ofCardiology, Available online 27 January 2017

Hansen TB, Zwisler AD, Berg S, Sibilitz K, Thygesen LC, Kjellberg J, Doherty P, Oldridge N, Søgaard R, Cost-utility analysis of cardiac rehabilitation after conventional heart valve surgery versus usual care. European Journal of Preventive Cardiology 2017; 0(00) 1-10. https: DOI: 10.1177/2047487317689908.

Vigorito C, Abreu A, Ambrosetti M, Belardinelli R, Corrà U, Cupples M, Davos CH, Hoefer S, Iliou MC, Schmid JP, Voeller H, Doherty P. Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section. Eur J Prev Cardiol. 2016 Dec 11. pii: 2047487316682579. [Epub ahead of print] PMID: 27940954

Sumner J, Grace S, Doherty P. Predictors of Cardiac Rehabilitation Utilization in England: Results from the National Audit. Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease (Elec). 2016; DOI: 10.1161/JAHA.116.003903

Rauch B, Davos C, Doherty P, Saure D, Metzendorf M-I, Salzwedel A, Vo¨ller H, Jensen K, Schmid JP. The prognostic effect of cardiac rehabilitation in the era of acute revascularization and statin therapy: a systematic review and meta-analysis of randomized and non-randomized studies. The Cardiac Rehabilitation Outcome Study - CROS. European Journal of Preventive Cardiology 2016. 0(00) 1-26. DOI: 10.1177/2047487316671181

Tang L, Zwisler AD, Kikkenborg Berg S, Doherty P, Taylor R, Langberg H. Is the cardiovascular response equivalent between a supervised centre-based setting and a self-care home-based setting when rating of perceived exertion is used to guide aerobic exercise intensity during a cardiac rehabilitation program? Am J Phys Med Rehabil 2016;00: 00-00. DOI: 10.1097/PHM.0000000000000628

Al Quait A, Doherty P. Does cardiac rehabilitation favour the young over the old? Open Heart 2016;3:e000450. doi:10.1136/openhrt-2016-000450

Greaves C, Wingham J, Deighan C, Doherty P, et al. on behalf of the REACH-HF investigators Optimising self-care support for people with heart failure and their caregivers: development of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) intervention using intervention mapping. BMC: Pilot and Feasibility Studies;2016,2:37

National Certification Programme for Cardiovascular Rehabilitation - aiming to improve practice
Furze, G., Nicols, S., Doherty, P. J., Hinton, S., Iliff, A. & Mills, J.
3 Nov 2016 Article in: Perspectives in Public Health. 136, 6, p. 318-320

Rehabilitation Enablement in Chronic Heart Failure-a facilitated self-care rehabilitation intervention in patients with heart failure with preserved ejection fraction (REACH-HFpEF) and their caregivers: rationale and protocol for a single-centre pilot randomised controlled trial
Eyre, V. , Lang, C. C. , Smith, K. , Jolly, K. , Davis, R. , Hayward, C. , Wingham, J. , Abraham, C. , Green, C. , Warren, F. C. , Britten, N. , Greaves, C. J. , Doherty, P. , Austin, J. , Van Lingen, R. , Singh, S. , Buckingham, S. , Paul, K. , Taylor, R. S. , Dalal, H. M. & 1 others
25 Oct 2016 Article in : BMJ open. 6, 10, 13 p., e012853

Harrison A, Sumner J, McMillan D, Doherty P. Relationship between employment and mental health outcomes following Cardiac Rehabilitation: an observational analysis from the National Audit of Cardiac Rehabilitation. International Journal of Cardiology (2016) 851-854. doi: 10.1016/j.ijcard.2016.06.142

Furze G, Doherty P, Grant-Pearce C. Development of a UK National Certification Programme for Cardiac Rehabilitation (NCP_CR). Br J Cardiol 2016;23:(2)doi:10.5837/bjc.2016.024

Rashid M, Shing Kwok C, Gale G, Doherty P, Olier I, Sperrin M, Kontopantelis E, Peat G, Mamas M. Impact of Co-morbid burden on mortality in patients with coronary heart disease, heart failure and cerebrovascular accident: A systematic review and meta-analysis. European Heart Journal - Quality of Care and Clinical Outcomes. DOI: qcw025 First published online: 10 May 2016

Piepoli M, Corra U, Dendale P, …..Doherty P et al. Challenges in secondary prevention after acute myocardial infarction: A call for action. European Journal of Preventive Cardiology: 2016: 0(00) 1-13. DOI: 10.1177/2047487316663873

Man W, Chowdhury F, Taylor R, Evans R, Doherty P, Singh S, Booth S, et al Building consensus for provision of breathlessness rehabilitation for patients with chronic obstructive pulmonary disease and chronic heart failure. Chronic Respiratory Disease; 2016:1-11: DOI: 10.1177/1479972316642363 Fell J, Dale V, Doherty P. Does the timing of cardiac rehabilitation impact fitness outcomes? An observational analysis. Open Heart. 2016 Feb 8;3(1):e000369. doi: 10.1136/openhrt-2015-000369. eCollection 2016

Taylor RS, Hayward C, Eyre V, Austin J, Davies R, Doherty P. et al. Clinical effectiveness and cost-effectiveness of the Rehabilitation Enablement in Chronic Heart Failure (REACH-HF) facilitated self-care rehabilitation intervention in heart failure patients and caregivers: protocol for a multicentre randomised controlled trial. BMJ Open 2015;5:e009994. doi:10.1136/bmjopen-2015- 009994

Exercise-based cardiac rehabilitation after heart valve surgery: cost analysis of healthcare use and sick leave
Hansen, T. B., Zwisler, A. D., Berg, S. K., Sibilitz, K. L., Thygesen, L. C., Doherty, P. J. & Sogaard, R.
2015 Article in : Open Heart. 2, 1

Doherty P, Harrison AS, Knapton M, Dale V. Observational study of the relationship between volume and outcomes using data from the National Audit of Cardiac Rehabilitation. Open Heart 2015; 2:e000304. doi:10.1136/openhrt-2015-000304

Dalal H, Doherty P, Taylor R. Clinical Review: Cardiac Rehabilitation. BMJ 2015;351:h5000 doi: 10.1136/bmj.h5000

Tang L, Zwisler A, Taylor R, Doherty P, Zangger G, Berg S, Langberg H. Self-rating level of perceived exertion for guiding exercise intensity during a 12-week cardiac rehabilitation programme and the influence of heart rate reducing medication. Journal of Science and Medicine in Sport. Sept 2015 Hansen TB, Zwisler AD, Berg SK, Doherty PJ, Søgaard R. Exercise-based cardiac rehabilitation after heart valve surgery: cost analysis of healthcare use and sick leave. Open Heart 2015;2:e000288. doi:10.1136/openhrt-2015-000288

Piepoli M, Corrà U, Abreu A, Cupples M, Davos C, Doherty P, Höfer S, Garcia-Porrero E, Rauch B, Vigorito C, Völler H, Schmid J-P. Challenges in secondary prevention of cardiovascular diseases: A review of the current practice. International Journal of Cardiology; 180:2015:114-119

Lewinter, C., Doherty, P., Gale, C. P., Crouch, S., Stirk, L., Lewin, R. J., LeWinter, M. M., Ades, P. A., Køber, L. & Bland, J. M. Exercise-based cardiac rehabilitation in patients with heart failure: a meta-analysis of randomised controlled trials between 1999 and 2013. Eur J Prev Cardiol. 2015 Dec;22(12):1504-12. doi: 10.1177/2047487314559853.

Schüler S, Mucha A, Doherty P, Kieser M, Rauch G. "Easily applicable multiple testing procedures to improve the interpretation of clinical trials with composite endpoints." Int J Cardiol. 2014 175(1): 126-132.

Lewinter C, Bland J M, Crouch S, Doherty P, Lewin B, Køber L, Hall A, & Gale C. The effect of referral for cardiac rehabilitation on survival following acute myocardial infarction: a comparison survival in two cohorts collected in 1995 and 2003. Eur J Prev Cardiol. 2014 Feb;21(2):163-71. doi: 10.1177/2047487312469124.

Joint British Societies' consensus recommendations for the prevention of cardiovascular disease (JBS3). Heart 2014;100:ii1-ii67. doi:10.1136/heartjnl-2014-305693

Lewinter C, Bland JM, Crouch S, Cleland J, Doherty P, LeWinter M, Køber L, Hall A, Gale C. Impact of aspirin and statins on long-term survival in patients hospitalized with acute myocardial infarction complicated by heart failure. An analysis of 1706 patients. European Journal of Heart Failure 2014; 16,95-102, doi:10.1002/ejhf.40

Rauch G, Kieser M, Ulrich S, Doherty P, Rauch B, Schneider S, ... Senges J. Competing time-to-event endpoints in cardiology trials: A simulation study to illustrate the importance of an adequate statistical analysis. Eur J Prev Cardiol 2014; 21(1), 74-80. 10.1177/2047487312460518

Buckley J, Furze G, Doherty P, Speck L, Connolly S, Hinton S, Jones J. British Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation: A Scientific Statement from the British Association for Cardiovascular Prevention and Rehabilitation (BACPR). BMJ Heart. 2013; 99 (15):1069-71; doi:10.1136/heartjnl-2012-303460

Lewin B, Doherty P. Cardiac rehabilitation and mortality reduction after myocardial infarction: evidence shows the emperor is properly dressed. Heart 2013;99:909-913. doi:10.1136/heartjnl-2013-303704

Doherty P, Rauch G. Cardiac rehabilitation mortality trends: how far from a true picture are we? BMJ Heart, 2013;99:593-595 doi:10.1136/heartjnl-2012-303365

Doherty P, Lewin B. The RAMIT trial, a pragmatic RCT of cardiac rehabilitation versus usual care: what does it tell us? BMJ Heart 2012;98:605-606 doi:10.1136/heartjnl-2012-301728

Use of NACR Data by External Researchers

The NACR is constituted to support cardiac rehabilitation programmes to deliver services to the highest standards and does this by contracting NHS Digital to collect data from all registered programmes. The NACR and NHS Digital have high quality safe guards in place which are agreed annually through 251 approvals and data governance agreements. As part of that process the NACR is not permitted to share data with any other party or allow direct access to data held by NHS Digital or the NACR.

These processes are important to ensure we abide by the data protection act and information governance agreements in respect of NACR data.

The NACR and its Steering Group continue to disseminate findings from the NACR through its annual report and peer reviewed journal papers. As part of this process we do on occasions invite clinicians and researchers, with expertise in relevant areas, to work with us on service improvement orientated projects and papers.

 The University of York