Research Priority Setting Project

Research Priority Setting Project

BACPR Research Priorities

As part of its work within the BHF-CRC, in 2019 the clinical study group (CSG) established by BACPR developed a protocol to identify research priorities within the field of cardiovascular prevention and rehabilitation (CVPR). Though project initiation was delayed due to the covid-19 pandemic, BHF-CRC funding for the project was secured in early 2021 and the project has since been completed. To view the 2019 project protocol please click here.

The project examined the evidence base for CVPR to identify unanswered research questions which were used to underpin three electronic surveys sent to members and partners of BACPR.  From these surveys the top 30 priority questions were identified and a top 10 list of questions finalised.  These questions will help BACPR shape future advancement of the CVPR research agenda.

The full project paper, including the final top 10 priority question list will be shared soon.  The top 30 priority questions are listed here and arranged across five key topic areas:

Access and Remote Delivery:

1.

What is the long-term clinical and cost-effectiveness of web-based interventions used in secondary prevention of coronary heart disease?

2.

What are the long-term effects of digital approaches to cardiac rehabilitation (including adverse events)?

3.

What is the best way to assess exercise remotely when a face-to-face test is not possible?

4.

How can assessment of health and digital literacy be incorporated into cardiac rehabilitation?

5.

Can digital health technology increase accessibility to cardiac rehabilitation for more diverse patient groups?

6.

Can cardiac rehabilitation programmes meet the needs of those with multi-morbidity?

Exercise and Physical Activity:

7.

What is the effectiveness of high intensity interval training versus moderate intensity continuous training at specific frequency, duration, and intensity for all coronary heart disease patients, and incorporating elderly and women?

8.

What is the optimal exercise-based cardiac rehabilitation frequency, intensity, time, and type to improve aerobic fitness in people diagnosed with coronary heart disease?

9.

Determine the benefit of regular exercise on survival in patients diagnosed with heart failure.

10.

Determine when to restart moderate to high intensity exercise and sport after an acute event and decompensated heart failure.

11.

Determine the safety profile of unsupervised home-based high intensity interval training following supervised exercise-based cardiac rehabilitation in patients diagnosed with cardiovascular disease.

12.

What is the definitive objective assessment of impact of exercise-based cardiac rehabilitation upon physical activity?

Optimising Outcomes from Programmes:

13.

What are the long-term clinical outcomes and adverse events across home-based, centre-based and hybrid exercise-based cardiac rehabilitation for those diagnosed with coronary heart disease?

14.

What is the efficacy of cardiac rehabilitation collaborative care management incorporating exercise, mental health, and behaviour strategies?

15.

Is a traditional 8-week comprehensive exercise-based cardiac rehabilitation multidisciplinary-delivered programme more clinically and cost-effective than usual practice?

16.

What is the clinical and cost-effectiveness of exercise-based cardiac rehabilitation upon symptoms and quality of life in those with stable angina?

17.

What is the optimal intensity and duration of behavioural change components required to achieve effective secondary prevention of coronary heart disease?

18.

What is the short and long-term clinical, cost-effectiveness and impact upon physical and psychological outcomes (including complications) of exercise-based cardiac rehabilitation following heart valve surgery?

19.

What are the long-term clinical outcomes from exercise-based cardiac rehabilitation in heart failure patients treated with cardiac resynchronisation therapy?

20.

How do content and intent of cardiac rehabilitation educational interventions compare on risk factors, behaviour, and hospitalisation in those diagnosed with coronary heart disease?

21.

Can the short-term benefits of exercise-based cardiac rehabilitation on exercise capacity in transplant patients be maintained in the longer term?

Psychosocial Health:

22.

What is the impact of physical and psychological components of cardiac rehabilitation on promoting return to work up to six months following diagnosis of coronary heart disease?

23.

What is the impact and acceptability of dedicated mental health practitioners delivering enhanced psychological care for patients with new-onset depression?

24.

What is the effectiveness of remote delivery of psychological support versus computerised cognitive behavioural therapy for anxiety and depression in patients with cardiac disease?

25.

What is the effect of mindfulness on mental health and risk factors in coronary heart disease patients with at least mild depression?

26.

What is the role of peer group sessions on normalising and reducing psychological stress in patients with cardiac disease?

The Impact of the Pandemic:

27.

Are there any adjustments needed to rehabilitation delivery and exercise prescription for individuals with long COVID?

28.

What impact on patient outcomes did the reduction in access to face-to-face general practice services and cardiac rehabilitation have?

29.

What is the long-term impact on patient health outcomes (major adverse cardiac events) in people who failed to access or delayed accessing healthcare services during the COVID-19 pandemic?

30.

How do the outcomes of traditional centre-based programmes compare to hybrid flexible delivery programmes that have developed during the pandemic?