1 minute conversation

1

Ask

if they know that many people with Ischaemic Heart Disease find that moving more really helps them

Common benefits reported by patients with ischaemic heart disease include:

  • improved energy
  • improved fitness
  • improved quality of life
  • improved blood flow around the body

Providing support and encouragement is important to help people to move towards a point where they will notice a benefit.

Encourage people to start with very small amounts of activity and build up gradually over 3-6 months.

2

Explain

that regular physical activity can help people to take control of their condition

The benefits of regular physical activity have been widely published. For adults, achieving 150 minutes a week of at least moderate intensity physical activity helps prevent and manage over 20 chronic conditions including coronary heart disease, stroke, type 2 diabetes, cancer, obesity, mental health problems and musculoskeletal conditions.

The risk of death from physical activity is extremely low. Large epidemiological cohorts report a death rate of approximately 1 death per 23 million hours of physical activity for men and 1 death per 36.5 million hours for women.

References

Whang W, Manson JE, Hu FB, et al. Physical exertion, exercise, and sudden cardiac death in women. JAMA. 2006;295(12):1399-1403.

Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE. Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med. 2000;343(19):1355-1361.

3

Invite

them to return to discuss their thoughts about being more active with you or a colleague and offer the patient information

Offer the “Patient information” printout on the benefits of physical activity for people with Ischaemic Heart Disease

Link to Patient Information Leaflet 

Did you know?

Your advice makes a difference

There is strong evidence for the effectiveness and cost effectiveness of counselling and brief advice on physical activity in healthcare.

References:

NICE. Physical activity: brief advice for adults in primary care primary care. Natl Inst Heal care Excell Public Heal Guidel 44 2013;PH44.nice.org.uk/guidance/ph44

NICE. Behaviour change: individual approaches | Guidance and guidelines | NICE. Natl Inst Heal Care Excell 2014;PH 49.https://www.nice.org.uk/guidance/ph49 (accessed 15 Feb 2018).

GC V, Wilson ECF, Suhrcke M, et al. Are brief interventions to increase physical activity cost-effective? A systematic review. Br J Sports Med 2016;50:408–17. doi:10.1136/bjsports-2015-094655

Ewald B, Stacey F, Johnson N, et al. Physical activity coaching by Australian Exercise Physiologists is cost effective for patients referred from general practice. Aust N Z J Public Health 2018;42:12–5. doi:10.1111/1753-6405.12733

Every conversation you have with people about physical activity is important in supporting behavioural change over the life course

Start small and build up gradually for a safe approach to starting activity

Habitually sedentary individuals may have unknown cardiovascular disease so should increase physical activity very gradually – suddenly doing vigorous intensity activity may increase risk of myocardial infarction in this inactive group by 100-fold

Those with active symptoms such as chest pain, acute breathlessness, palpitations signs of heart failure may have serious underlying pathology and should be referred for specialist investigation

References:
Thompson PD, Arena R, Riebe D, Pescatello LS, Medicine ACoS. ACSM’s new preparticipation health screening recommendations from ACSM’s guidelines for exercise testing and prescription, ninth edition. Curr Sports Med Rep. 2013;12(4):215-217.