Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study

Objectives This study aimed to generate new qualitative insights to understand the rehabilitation needs of people living with a confirmed or presumed diagnosis of ischaemia with no obstructive coronary arteries (INOCA), explore which aspects of current cardiovascular prevention and rehabilitation pr...

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Main Authors: Simon Nichols, Colin Berry, Aynsley Cowie, Sarah Brown, Helen Humphreys, Susan Dawkes, Danielle Paddock
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/12/e086770.full
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author Simon Nichols
Colin Berry
Aynsley Cowie
Sarah Brown
Helen Humphreys
Susan Dawkes
Danielle Paddock
author_facet Simon Nichols
Colin Berry
Aynsley Cowie
Sarah Brown
Helen Humphreys
Susan Dawkes
Danielle Paddock
author_sort Simon Nichols
collection DOAJ
description Objectives This study aimed to generate new qualitative insights to understand the rehabilitation needs of people living with a confirmed or presumed diagnosis of ischaemia with no obstructive coronary arteries (INOCA), explore which aspects of current cardiovascular prevention and rehabilitation programmes could meet the needs of people with INOCA and where adjustments (if any) may be appropriate.Design Semistructured qualitative interview study.Participants Interviews were undertaken (n=17; 88% female, age range 31–69 years) with people with a confirmed or presumed diagnosis of INOCA.Results Findings highlighted concerns around a lack of evidence-based guidance for cardiovascular prevention and rehabilitation programmes for patients with INOCA. Participants expressed a desire for modular cardiovascular prevention and rehabilitation programmes that could be accessed flexibly to accommodate episodic fluctuations in symptoms. Participants suggested that existing cardiovascular prevention and rehabilitation programme content needed adjustment including enhanced psychosocial support, supervised low-impact physical activity and specialist dietary advice and medication reviews. Additional elements specific to INOCA should be made available as appropriate including acute care planning and a module to provide information and support for female-specific issues. The importance of involving INOCA patients in the codesign of future programmes and associated training was emphasised.Conclusions People with INOCA are willing to engage with cardiovascular prevention and rehabilitation programmes and express a desire for more support. This patient group shares some barriers to rehabilitation programme attendance with other cardiac patient groups, but they also have specific concerns about the need for improved professional knowledge and evidence-based guidance regarding the management of INOCA. Cardiovascular rehabilitation programmes need to be delivered flexibly and individually tailored to ensure the relapsing and remitting nature of INOCA and associated support needs are addressed.
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spelling doaj-art-f8a89542f34f4c2cbbbf6e5e82025e2c2024-12-17T13:30:13ZengBMJ Publishing GroupBMJ Open2044-60552024-12-01141210.1136/bmjopen-2024-086770Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview studySimon Nichols0Colin Berry1Aynsley Cowie2Sarah Brown3Helen Humphreys4Susan Dawkes5Danielle Paddock66 Edinburgh Napier University, Edinburgh, UK5 BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK4 Cardiac Rehabilitation, NHS Ayrshire and Arran, Kilmarnock, UK2 International Heart Spasms Alliance, London, UK1 Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK6 Edinburgh Napier University, Edinburgh, UK1 Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UKObjectives This study aimed to generate new qualitative insights to understand the rehabilitation needs of people living with a confirmed or presumed diagnosis of ischaemia with no obstructive coronary arteries (INOCA), explore which aspects of current cardiovascular prevention and rehabilitation programmes could meet the needs of people with INOCA and where adjustments (if any) may be appropriate.Design Semistructured qualitative interview study.Participants Interviews were undertaken (n=17; 88% female, age range 31–69 years) with people with a confirmed or presumed diagnosis of INOCA.Results Findings highlighted concerns around a lack of evidence-based guidance for cardiovascular prevention and rehabilitation programmes for patients with INOCA. Participants expressed a desire for modular cardiovascular prevention and rehabilitation programmes that could be accessed flexibly to accommodate episodic fluctuations in symptoms. Participants suggested that existing cardiovascular prevention and rehabilitation programme content needed adjustment including enhanced psychosocial support, supervised low-impact physical activity and specialist dietary advice and medication reviews. Additional elements specific to INOCA should be made available as appropriate including acute care planning and a module to provide information and support for female-specific issues. The importance of involving INOCA patients in the codesign of future programmes and associated training was emphasised.Conclusions People with INOCA are willing to engage with cardiovascular prevention and rehabilitation programmes and express a desire for more support. This patient group shares some barriers to rehabilitation programme attendance with other cardiac patient groups, but they also have specific concerns about the need for improved professional knowledge and evidence-based guidance regarding the management of INOCA. Cardiovascular rehabilitation programmes need to be delivered flexibly and individually tailored to ensure the relapsing and remitting nature of INOCA and associated support needs are addressed.https://bmjopen.bmj.com/content/14/12/e086770.full
spellingShingle Simon Nichols
Colin Berry
Aynsley Cowie
Sarah Brown
Helen Humphreys
Susan Dawkes
Danielle Paddock
Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study
BMJ Open
title Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study
title_full Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study
title_fullStr Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study
title_full_unstemmed Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study
title_short Exploring patients’ views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries: a qualitative interview study
title_sort exploring patients views regarding the support and rehabilitation needs of people living with myocardial ischaemia and no obstructive coronary arteries a qualitative interview study
url https://bmjopen.bmj.com/content/14/12/e086770.full
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