Implementing Cardiac Rehabilitation as a First-Line Treatment for Stable Angina Pectoris: PERSPECTIVES OF CARDIOLOGISTS AND PATIENTS

Verkerk, EW, Deuning-Smit, E, Beernink, N, Schlief, ATEF, Heutinck, JM, de Koning, IA, Kemps, HMC, Thijssen, DHJ ORCID: 0000-0002-7707-5567 and Kool, RB (2026) Implementing Cardiac Rehabilitation as a First-Line Treatment for Stable Angina Pectoris: PERSPECTIVES OF CARDIOLOGISTS AND PATIENTS. Journal of Cardiopulmonary Rehabilitation and Prevention. ISSN 1932-7501

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Abstract

Purpose: – Cardiac rehabilitation (CR) is a promising treatment for patients with stable angina pectoris (SAP) and has been postulated as a safe and effective alternative to revascularization in low-risk patients. We assessed the barriers and facilitators for the implementation of CR for patients with SAP. Methods: – We interviewed 12 clinicians (cardiologists and CR case managers) and 6 patients to assess perceived and expected barriers and facilitators in choosing CR as first-choice treatment for SAP in the Netherlands. The interviews were analyzed both inductively and deductively using the theoretical domains framework. Results: – We found a total of 44 barriers and 28 facilitators across 8 themes. Clinicians reported the following key barriers: lack of evidence and clarity in guidelines; knowledge gaps about the outcomes, treatment indication, and content of CR; higher perceived effort to discuss CR compared with a revascularization; a lack of support from colleagues and authorities; suboptimal treatment decision-making conditions; beliefs that affect openness to CR; and the organization/funding of care. Clinicians indicated these facilitators: their belief in CR and motivation to provide the best and affordable care. Patients reported no major barriers. As facilitators, patients indicated openness to CR and trust in the clinician advice. Conclusion: – Clinicians experience barriers to propose CR as an initial treatment strategy rather than revascularization in patients with SAP despite their motivation and belief in CR. Clinicians require more evidence, awareness of the existing evidence, clarity in guidelines, and support from their professional association.

Item Type:	Article
Uncontrolled Keywords:	angina stable; cardiac rehabilitation; exercise therapy; implementation; interview study; 4203 Health Services and Systems; 32 Biomedical and Clinical Sciences; 42 Health Sciences; Rehabilitation; Behavioral and Social Science; Cardiovascular; Physical Rehabilitation; Clinical Research; 7.1 Individual care needs; 1102 Cardiorespiratory Medicine and Haematology; Cardiovascular System & Hematology; 3201 Cardiovascular medicine and haematology; 4201 Allied health and rehabilitation science
Subjects:	R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC1200 Sports Medicine R Medicine > RM Therapeutics. Pharmacology
Divisions:	Sport and Exercise Sciences
Publisher:	Lippincott, Williams & Wilkins
Date of acceptance:	8 June 2026
Date of first compliant Open Access:	29 September 2026
Date Deposited:	29 Sep 2026 14:11
Last Modified:	29 Sep 2026 14:11
DOI or ID number:	10.1097/HCR.0000000000001066
URI:	https://researchonline.ljmu.ac.uk/id/eprint/29564

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