BACPR Annual Conference 2019 ‘Cardiovascular Disease and Multimorbidity’ East Midlands Conference Centre 3Rd and 4Th October 2019

BACPR Annual Conference 2019 ‘Cardiovascular Disease and Multimorbidity’ East Midlands Conference Centre 3rd and 4th October 2019

Please use follow us #bacpr2019 on Twitter www.bacpr.com on twitter for conference tweets @bacpr Welcome BRITISH ASSOCIATION FOR CARDIOVASCULAR PREVENTION AND REHABILITAT ION Welcome to the BACPR Annual Conference 2019. Thank you for making the trip to Nottingham for what promises to be an exciting programme. As many of you will have noticed, the type of patient entering cardiovascular rehabilitation programmes has changed significantly in recent years, andCardiovascular Disease and Welcome and congratulations for making it to what promises to Multimorbidity is becoming increasingly common. We hope that be another top class BACPR conference. We are in the “Heart” the theme of this year’s conference will generate lots of ideas on of England this year in the beautiful setting of Nottingham how to further develop the fantastic work that is already going within University Campus. We have our usual high quality, diverse cardiovascular rehabiliation. program of talks to hopefully stimulate your enthusiasm. Simon has covered everything above and again he has worked We are delighted to welcome so many excellent speakers to this year’s annual conference, extremely hard (and efficiently!) to keep the momentum going and I am sure that they will provide an extremely diverse range of topics for us to discuss. in the organisation of this event. I would like to echo a major We are extremely grateful for the support provided by our sponsors, so please take time to thanks to all the BACPR team working behind the scenes to visit their exhibitor stands. Sanofi will be holding a lunchtime symposium on Thursday, and make this a reality; this includes our partners and sponsors this Astra Zeneca, will be holding a lunchtime symposium on Friday. NACR will also be holding year. two workshops. During the Thursday afternoon healthy break, they will discuss ‘What are the barriers to assessment?’, and during the Friday lunch break, they will discuss ‘What is Without the continued support of our members (Hopefully you!) completion?’ this organisation would not be in the rude health we currently enjoy. Thank you all for your continued support and belief Immediately after the close of Thursday’s session, you are invited to attend the BACPR’s that we are doing the right thing in attempting to improve and AGM and enjoy a glass of wine. This will take place in Conference Suite 2. champion prevention and rehabilitation as the “underdog” of We look forward to celebrating the continued success of our association and catching up Cardiology services. I hope you do get the chance over the next with members and guests at the gala dinner on Thursday evening. If you are attending the few days to learn and reflect, whilst catching up with friends. dinner, please remember to add your name to the table plan located near the registration The multimorbid world is already upon us with an approaching desk. In a change of format used in previous years, this year’s gala dinner will celebrate “sickness tsunami” I hope you get some tips to help you “surf to the success of delegates and speakers. During the dinner, we will present awards to the safety” at your own workplace! winner of the ‘New Researcher Development Fund’, ‘Best Moderated Poster’, and the ‘New This is my last conference and indeed final moments with Investigator Award’. The evening will conclude with a disco and opportunity to socialise. BACPR, as I hand over to the brilliant Prof Susan Dawkes. I am Then, if your feet have recovered from the dance floor, please join our walk / jog, which will grateful to all of you for the support you have given me over the leave from the hotel reception at 7am on Friday. last two years and I do hope that you feel BACPR is somewhat We look forward to presenting the award for ‘Best Oral Abstract’ immediately after the better off for having had me steer the ship for a short voyage. morning break on Friday. From Monday 28th October, visit the members’ area of www. Best Wishes bacpr.com to access some of the presentation slides. Details of all of the abstracts accepted for this year’s conference will be available through the Research Network located within the Research Hub of the BACPR website. Dr Scott W Murray Following its popularity at the 2018 annual conference, I am pleased to say that we will be BACPR President (2017-2019) using Slido technology again. You will be able to get fully involved in the Q&A with speakers in all of the main speaker session on Thursday and Friday. Also remember to tweet @bacpr, using #bacpr19. Finally, a huge thanks from myself to our conference team – Sally Hinton, Scott Murray, Susan Dawkes, Aynsley Cowie, Vivienne Stockley and Valerie Collins – all of whom have worked extremely hard all year in preparing this conference. We hope you enjoy the conference!

Dr Simon Nichols BACPR Scientific Chair

2 BACPR Annual Conference 2019 Contents

Useful Information 4 Where am I going? 5 Programme Thursday 6 Friday 7 Exhibitors 9 Main Conference Sessions Speakers 12 Lunchtime Workshops 35 Chairpersons 36 Oral Abstract Presentations 40 Moderated Posters 45 Posters 46 Notes 50 Future Diary Dates 51

‘Cardiovascular Disease and Multimorbidity’ 3 Useful Information

BACPR membership and General Enquiries Valerie Collins [email protected] 0207 3801919 BACPR Education and Training Vivienne Stockley [email protected] 01252 854510 Venue Details East Midlands Conference Centre (EMCC) Beeston Lane, The University of Nottingham, Nottingham NG7 2RJ 0115 876 0900 Registration If you have any queries during the conference, please visit the registration desk which is outside Conference Suite 1. Evaluation Every year we try to use delegate feedback in our conference planning. Please complete our online survey, details of which will be emailed to you during the conference. Mobile Phones As a courtesy to the speakers and other delegates, please switch your mobile phones to silent while the conference is in progress. Social Media Follow us on twitter @bacpr and tweet about the event using #bacpr2019 Slido This year we will be using Slido technology to help you become more involved in the Q&A with speakers. Listen out for the demonstration on how to use Slido at the start of Session 1. Read Again From Monday 28th October, visit the website to access speakers’ presentations within the members’ area, and details of all abstracts submitted within the Research Network. Keeping Active We appreciate that conference tends to encourage sedentary behaviour! Combat this by joining our walk / jog, which will leave from the hotel reception at 7am on Friday 4th October. This will be suitable for a range of fitness levels. www.bacpr.com

4 BACPR Annual Conference 2019 Where am I Going?

Conference Suite 2 ♥ NACR workshops (Thurs break afternoon and Fri lunchtime) ♥ AGM ( Thurs 5.30 - 6.00) ♥ Oral Abstract presentations (Fri Session 5)

Conference Suite 1 ♥ Posters ♥ Moderated Poster Session ( Thurs afternoon break)

Registration and Exhibition Area

Main Conference Room ♥ Main conference sessions ♥ Lunchtime symposia

If you have any queries, please speak to a member of the conference team or visit the registration desk.

‘Cardiovascular Disease and Multimorbidity’ 5 THURSDAY 3rd OCTOBER 2019 Registration opens from 9.00am

Session 1: Chairs: Sally Hinton & Dr Aynsley Cowie 10:00-10:05 Housekeeping Dr Simon Nichols Senior Research Fellow at Opening – Why Multimorbidity? Sheffield Hallam University & BACPR Scientific Officer 10:05-10:10 Welcome From BACPR And Dr Scott Murray Consultant Cardiologist at Royal President Handover Liverpool University Hospital & BACPR President Prof Susan Dawkes Edinburgh Napier University 10:10-10:35 Keynote: Fast Forwarding Dr Paddy Barrett Consultant Cardiologist at Disruptive Prevention To Blackrock Clinic, Dublin, Ireland Rewind Unhealthy Futures 10:35-11:00 Determinants Of Uptake, Patrick Doherty Chair in Cardiovascular Health Completion And Outcomes In and Director of the BHF National Audit of Cardiac Multimorbid Patients Attending Rehabilitation at the University of York Cardiac Rehabilitation Alex Harrison Research Fellow/Statistician BHF National Audit of Cardiac Rehabilitation University of York 11:00-11:10 Comfort Break 11:10-11:35 Coal-Face Cardiogeriatrics: Dr Shuli Levi Consultant Physician in Cardio-Geriatric Optimising Multimorbidity In Medicine at Imperial College Healthcare NHS Trust Acute Cardiology Patients 11:35-12:00 The Role Of Exercise Therapy Dr Malcolm Walker Consultant Cardiologist, In Cardio-Oncology Clinical Lead University College London Hospitals, Clinical Director Hatter Cardiovascular Institute UCLH 12:00-12:25 Dietary Management Of Type Dr Nicola Guess Lecturer in Nutrition at 2 Diabetes: Myths And Facts? Kings College London 12:25-12:35 Panel Discussion And Questions To All Presenters 12:35-13.40 Lunch And Networking, Stands And Posters 13:00-13:30 Symposia - Sanofi (Banqueting Suite) Session 2: Chairs: Dr Scott Murray & Dr Simon Nichols 13:40-14:05 Heart Failure Update 2019 Dr Simon Williams Consultant Cardiologist at Wythenshawe Hospital and Chair of the British Society for Heart Failure 14:05-14:30 Saving Heart And Minds Prof Jamie Waterall National Lead for Together: New CVD Prevention Cardiovascular Disease Prevention & Associate Ambitions For England Deputy Chief Nurse at Public Health England 14:30-14:50 New Researcher Development Introduction Fund Proposals Finalist 1 - Tim Grove Finalist 2 - Conor Kerley 14:50-15:45 Healthy Break, Stands And Posters 15:00-15:40 NACR Workshop 1 (Conference Suite 2) 15:00-15:40 Moderated Posters

6 BACPR Annual Conference 2019 Session 3: Chairs: Jo Hayward & Alison Allen 15.45-16.10 Cardiologist’s Kitchen Dr Ali Khavandi Consultant Interventional Cardiologist, Royal United Hospitals NHS Foundation Trust 16:10-16:35 Groove Is In The Heart: Prof Costas Karagheorghis Divisional Lead for Sport, Optimising Music Applications Health & Exercise Science at Brunel University In Cardiac Rehabilitation 16:35-17:20 Interactive Case Studies In CR Dr Joseph Mills BACPR Past President MDT panel: Dr Tom Butler - Dietician Dr Carolyn Deighan - Psychologist Alison Allen - Nurse Brian Begg - Exercise Physiologist 17.30-18.00 BACPR AGM (Conference Suite 2) THURSDAY EVENING EVENTS 19:30-20:00 Drinks Reception 20:00-22:00 Gala Dinner And Awards 22:00 – late Disco FRIDAY 4th OCTOBER 2019 7:00 Walk / Run From 8:30 Day Delegate Registration Session 4: Digital Workshop Session 5: Oral Abstracts Chairs: Sally Hinton & Chairs: Sheona McHale & Ceri Roberts Gillian Farthing 9.00 - 9.15 9.00 – 9.15 Is There A Difference In Exercise Capacity Outcomes Introduction In Heart Failure Patients With And Without Atrial Fibrillation Whilst Kelly Read, Clinical Development Attending A Heart Failure Rehabilitation Programme? Coordinator, British Heart Foundation Nikki Gardiner Clare Thomson, Senior Project 9.15 – 9.30 Do Comorbidities Determine The Improvement In Manager, Cardiac Clinical Network, Depression In Patients With New Onset Depressive Symptoms NHS England Following Cardiac Rehabilitation? Serdar Sever 9.15 - 10.15 9.30 – 9.45 What works for supporting health behaviour change Short presentations on Digital in cardiovascular health promotion? Prof Colin Greaves Innovations in Cardiac Rehab 9.45 – 10.00 Cardiovascular And Cardiorespiratory Adaptations To Routine Exercise-Based Cardiac Rehabilitation (CARE CR) Dr Simon Nichols 10.00 – 10.15 Understanding The Facilitators And Barriers To Exercise After Stroke Among Patients, Exercise Professionals And Clinicians. Bethany Moyle

10:15-10:45 Healthy Break

Session 6: Chairs: Dr Hayes Dalal & Gill Farthing 10.45-10.50 Award For Best Oral Abstract Dr Scott Murray Consultant Cardiologist at Royal Liverpool University Hospital & BACPR President

‘Cardiovascular Disease and Multimorbidity’ 7 10.50-11.00 Update from BACPR Diet Dr Tom Butler Senior Lecturer in Nutrition and Working Group Dietetics, University of Chester 11.00-11.15 HDL, LDL and Triglycerides: The Dr Tom Heseltine Royal Liverpool and Broadgreen Good, The Bad and The Ugly University Hospitals NHS Foundation Trust 11:15-11:40 Integrating Pharmacy In To Dr Rani Khatib Consultant Pharmacist in Cardiology The Cardiac Rehabilitation and Cardiovascular Research at Leeds Teaching Pathway Hospitals NHS Trust, and The University of Leeds 11:40-12:00 Combining Prevention And Dr Vicky Pettemerdies Post CCT Fellow in Advanced Rehabilitation With Cardiology Echo and Inherited Cardiac Conditions , Manchester Sub-Specialisation – What Are University NHS Foundation Trust The Barriers To Change? 12:00-12:25 Reimagining Cardiac Sally Hughes Head of Health Services Engagement Rehabilitation Services – British Heart Foundation Ambitions and Opportunities 12.25-13.35 Lunch And Networking, Stands And Posters 12:45-13:15 Symposium - Astra Zeneca (Banqueting Suite) 12:35-13:15 NACR Workshop 2 (Conference Suite 2)

Session 7: Chairs: Prof Susan Dawkes & Dr Carolyn Deighan 13:35-14:00 Breathlessness in COPD and Prof Sally Singh Professor of Pulmonary and Cardiac Chronic Heart failure Rehabilitation at Coventry University 14:00-14:20 Designing Interventions For Dr Helen Speake Exercise Psychology Research Multimorbid Populations: Fellow at Sheffield Hallam University Involving The End User 14:20-14:40 Exercise Referral Schemes Dr Coral Hanson Research Fellow, Cardiovascular – Access, Adherence And Health Theme at Edinburgh Napier University Multimobidity 14:40-15:00 Delivering A Specialist- Dr Aynsley Cowie Consultant Physiotherapist in Generalist Rehabilitation Model Cardiology at University Hospital Crosshouse, NHS In Practice Ayrshire and Arran 15:00-15:25 Care After Resuscitation Dr Thomas Keeble Consultant Cardiologist Senior Research Fellow Anglia Ruskin School of Medicine 15.25-15.30 Closing Remarks And Evaluation

Visit www.bacpr.com for further information on registration, travel and accommodation.

Follow @bacpr on Twitter for conference updates #bacpr2019

BRITISH ASSOCIATION FOR CARDIOVASCULAR PREVENTION AND REHABILITAT ION

BACPR, c/o BCS, 9 Fitzroy Square, London W1T 5HW Tel: 020 7380 1919 Email: [email protected]

8 BACPR Annual Conference 2019 BACPR would like to thank the following exhibitors and partner organisations for their valued support

AstraZeneca is a global, innovation-driven biopharmaceutical business that focuses on the discovery, development and commercialisation of prescription medicines, primarily for the treatment of diseases in three main therapy areas – respiratory, inflammation, autoimmune disease (RIA), cardiovascular and metabolic disease (CVMD) and oncology – as well as in infection and neuroscience. AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide. www.astrazeneca.co.uk

Sanofi is dedicated to supporting people through their health challenges. We are a global biopharmaceutical company focused on human health. We prevent illness with vaccines, provide innovative treatments to fight pain and ease suffering. We stand by the few who suffer from rare diseases and the millions with long-term chronic conditions. www.sanofi.co.uk

The Association of Chartered Physiotherapists in Cardiovascular Rehabilitation (ACPICR) is a professional network of the Chartered Amgen is committed to unlocking the potential of biology for Society of Physiotherapy. Formed in 1995, the ACPICR welcomes patients suffering from serious illnesses by discovering, developing, professionals who are working in or interested in the exercise/physical manufacturing and delivering innovative human therapeutics. This activity components of cardiac rehabilitation. The ACPICR provides, in approach begins by using tools like advanced human genetics association with the British Association for Cardiovascular Prevention to unravel the complexities of disease and understand the and Rehabilitation high standard education via well established and well fundamentals of human biology. evaluated post graduate courses. ACPICR also develop and produce www.amgen.co.uk documents and resources to facilitate and support clinical excellence in cardiac rehabilitation. More information on the ACPICR and ACPICR publications can be found at; www.acpicr.com

The Angina Plan is an evidence-based intervention designed to help Angina patients help themselves in managing this chronic condition. Sometimes called a cognitive-behavioural programme, it targets thoughts, emotions and behaviours. It also promotes and encourages behaviour change to manage risk factors, support The Australian Cardiovascular Health and Rehabilitation Association exercise and physical activity, tackles the misconceptions about is the peak body which provides support and advocacy for angina and uses relaxation to help patients control emotional multidisciplinary health professionals to deliver evidence-based best responses. practice across the continuum of cardiovascular care. We aim to www.anginaplan.org.uk empower health professionals to achieve optimal and equitable outcomes for all affected by cardiovascular disease. www.acra.net.au

‘Cardiovascular Disease and Multimorbidity’ 9 BACPR would like to thank the following exhibitors and partner organisations for their valued support

The British Society of Heart Failure aims to maximise Health Care Professionals influence in improving the delivery of equitable, high quality heart failure care in the UK, measurably improving patient outcomes Arrhythmia Alliance is a coalition of charities, professional medical and experience. organisations and industry groups that works to promote the timely diagnosis and effective management of arrhythmias. By raising awareness www.bsh.org.uk and campaigning for the improved detection and care of heart rhythm disorders, Arrhythmia Alliance aims to extend and improve the lives of the millions around the world that these conditions effect. www.heartrhythmcharity.org.uk

The Canadian Association of Cardiovascular Prevention and Rehabilitation (CACPR) is a national body comprised of interdisciplinary health professionals. Our focus is enhancing knowledge and clinical care, as well as enabling research for those who work in cardiovascular prevention and rehabilitation. Avegen is the digital healthcare company building HealthMachine. Avegen’s HealthMachine enables cardiac rehab teams to provide www.cacpr.ca personalized care to patients, improve patient uptake, and streamline NACR reporting. www.avegenhealth.com

Diabetes UK is leading the fight against the most devastating and fastest growing health crisis of our time, to create a world where diabetes can do no harm. We work with healthcare professionals to deliver the best diabetes treatment and care, by sharing knowledge, driving clinical improvement Heart and circulatory diseases are the world’s biggest killers. That’s why and growing leaders. we fund over £100 million of research each year into conditions like heart www.diabetes.org.uk attacks and heart failure, stroke, vascular dementia and their risk factors like diabetes and high blood pressure. We’ve used the research we have funded to develop best practice programmes that have transformed the care of people affected by heart and circulatory diseases, so we can end the heartbreak these conditions cause. www.bhf.org.uk At Human Kinetics, our mission is to produce innovative, informative products in all areas of physical activity that help people worldwide lead healthier, more active lives. We are committed to providing quality informational and educational products in physical activity and health fields that meet the needs of our customers. www.humankinetics.com

10 BACPR Annual Conference 2019 BACPR would like to thank the following exhibitors and partner organisations for their valued support

The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) brings together 34 cardiac rehabilitation- related clinical societies globally, to promote and augment cardiac The Heart Manual Programme, NHS Lothian, is the UK’s leading self- rehabilitation as per our international Charter; we are a member of management resource for individuals with cardiac conditions. the World Heart Federation. Our activities have included a consensus Supported by trained facilitators UK wide and further afield, it is statement on CR delivery in low-resource settings with corresponding substantiated by a wealth of empirical evidence including 3 RCTs, healthcare professional certification program, an audit and survey and specified in NICE as a comprehensive programme validated for of cardiac rehab programs globally, and a policy statement on patients with MI/revascularisation. Book or digital formats are available. promoting CR utilization. ‘Proven to work’ (NACR 2016)-this sustainable model has been www.Globalcardiacrehab.com adapted into other conditions e.g. Cancer. www.theheartmanual.com

my mhealth are the leading supplier of self-management and rehabilitation apps and platforms in the UK for patients with COPD, Asthma, Diabetes and Heart Disease, supplying over 100 CCGs in NHS England and several health boards in Scotland and Wales. Our apps deliver an evidence based, highly secure, and immersive Web-based rehabilitation solutions from the Centre for Exercise and experience that impacts significantly on patient outcomes and Rehabilitation Science (CERS)- University Hospitals of Leicester NHS healthcare utilisation. Trust. Our online cardiac and pulmonary rehabilitation packages allow www.linc-medical.co.uk patients the flexibility to complete a supported programme in their own time. www.activateyourheart.org.uk

Novartis provides innovative healthcare solutions that addresses the evolving needs of patients and societies. Headquartered in Basel, Switzerland, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, eye care and cost saving generic pharmaceuticals. Enthusiastic and responsive, the University of Chester is committed www.novartis.co.uk to providing the very best in teaching, learning, research, student support and partnerships. www.chester.ac.uk/postgraduate/cvr

The Primary Care Cardiovascular Society (PCCS) is a multi-disciplinary society with nearly 100 members made up of GPSIs, clinical champions, specialist nurses and pharmacists. The PCCS promotes best practice in primary care cardiovascular health through education, training and service development www.pccsuk.org

‘Cardiovascular Disease and Multimorbidity’ 11 Main Conference Sessions Speakers Session 1; Thursday 10.05 – 10.10

Opening Address Dr Scott Murray

Consultant Cardiologist and Clinical Lead for Preventive Cardiology / Royal Liverpool and Broadgreen University Hospital NHS Trust Scott first graduated from Glasgow University in 1999 with a First Class Honours BSc in Sports and Exercise Medicine. His initial BSc research work was presented at the American Heart Association and involved BNP and ACE genotype work in Athletic LVH. During training in Cardiology, he specialised in Interventional Cardiology and in particular intra-vascular imaging (IVUS) in stable and unstable coronary artery disease. He spent short periods in Rotterdam and in Virgina, USA trying to use intra-vascular ultrasound and Cardiac CT to hunt down the “vulnerable plaque”. This work led to numerous publications, awards and the post-graduate MD degree from The University of Liverpool. Having spent 10 years focussed on this, he decided to give up his stent habit to campaign and work towards comprehensive CVD prevention and rehabilitation strategies for Liverpool and the UK. He is now finishing his term as President of BACPR but intends to continue working towards improving all interventions that may activate a “vulnerable patient”.

Professor Susan Dawkes

Professor Susan Dawkes is a registered nurse who has spent over twenty years working with cardiology patients in Scotland and Canada. Her clinical roles included nursing in acute cardiology units and latterly working as a specialist nurse in cardiac rehabilitation. Susan is currently the Director of Learning, Teaching and Assessment in the School of Health and Social Care at Edinburgh Napier University and an Honorary Research Consultant in the Cardiology Department of NHS Lothian. Susan is President Elect of the British Association of Cardiovascular Prevention and Rehabilitation (BACPR) and represents BACPR on the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR). She is a member of the Association of Cardiovascular Nursing and Allied Professions (ACNAP) Education Committee for the European Society of Cardiology. Susan is on the editorial board of the British Journal of Cardiac Nursing and she is working nationally to improve the education of healthcare professionals in relation to secondary prevention of heart disease and rehabilitation.

12 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 1; Thursday 10.10 – 10.35

Dr Paddy Barrett Fast Forwarding Disruptive Prevention to Rewind Unhealthy Futures

Dr Paddy Barrett is a Consultant Cardiologist at The Blackrock Clinic, Dublin with a special interest in how novel technologies will shape the future of medicine. Having trained in San Diego, California at the Scripps Translational Science Institute his research has focused on digital medicine technologies in healthcare, the physiology of microgravity during NASA parabolic flight campaigns and the biometric signatures of emotional states. In addition to hosting the internationally acclaimed podcast series ‘The Doctor Paradox’, his work has featured in Time Health, The New York Academy of Sciences, The New England Journal of Medicine and The Lancet.

Fast Forwarding Disruptive Prevention to Rewind Unhealthy Futures From wearable sensors to artificial intelligence digital medicine has been proposed as a step function solution to improving medical care. Despite significant progress in digital health technologies, the question remains whether we are witnessing the early phase of an immature but promising solution or a substantially overhyped approach to tackling the major unmet needs of cardiovascular disease. With the increasing motivation to shift care from hospital- based solutions to home-based management the promise of the digital medicine revolution is indeed appealing. But is the expectation based in reality or have we been duped by excess hype in the desire to provide disruptive technologies to prevent the growing burden of cardiovascular disease in today’s world? The answer it would seem is it depends.

‘Cardiovascular Disease and Multimorbidity’ 13 Main Conference Sessions Speakers Session 1; Thursday 10.35 – 11.00

Professor Patrick Doherty/ Alex Harrison Determinants of Uptake, Completion and Outcomes in Multimorbid Patients attending Cardiac Rehabilitation

Professor Patrick Doherty is Chair of Cardiovascular Health in Department of Health Sciences at University of York where he leads the BHF Cardiovascular Health Research Group. Patrick is Director of the BHF National Audit of Cardiac Rehabilitation (NACR), which monitors the quality and outcomes of CR services and aims to drive innovation so that all eligible patients benefit. As NHS Clinical Lead for Cardiac Rehabilitation (2008 to 2012), he led the development of the Department of Health ‘Cardiac Rehabilitation Commissioning Pack’. Patrick is a Past President of the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) and former Chair of the ‘Cardiac Rehabilitation Section’ of the European Association for Preventive Cardiology (2014-2016). He has over 40 published papers in the last three years, which aim to drive high- quality service delivery for the benefit of all eligible patients. Working closely with the BACPR, Patrick co-leads the National Certification Programme for CR (NCP_CR). The NCP_CR evaluates the extent by which all registered rehabilitation programmes meet key performance indicators for quality service delivery. Through the combined efforts of the BHF, NACR and BACPR they promote good practice and drive innovation in service delivery. Alexander joined the Department of Health Sciences in 2014 as a data analyst and since become a Research Fellow specializing in Observational Studies in Cardiac Rehabilitation. He has experience in a range of research designs including observational, randomized control trials and systematic reviews. Alex’s current area of interest is factors affecting outcomes in complex interventions; specifically looking at the different modes of delivery and their impact on risk factors, psychosocial wellbeing and physical fitness. Determinants of Uptake, Completion and Outcomes in Multimorbid Patients attending cardiac Rehabilitation Comorbidity Profile, Burden and Outcomes in Modern UK Cardiac Rehabilitation Introduction: The proportion of patients attending cardiac rehabilitation (CR) with two or more comorbidities is greater than 50% (NACR 2019). This observational analysis focused on patients with comorbidities and their outcomes post CR. Method: Using NACR data from patients who completed CR in 2017/2018, the study aimed to compare patients with varying levels of comorbidities to identify differences in five risk factors. These included smoking, physical activity, BMI, anxiety and depression. Results: 39,644 patients (male 22,010 + female 7,847) were identified, mean age for all patients attending CR was 66 (11 SD). Patients with two or more comorbidities had longer waiting times of 4 days; however, they had longer duration by 4 days. Patients with two or more comorbidities had greater proportion within negative risk states such as smoking. Regression analysis identified that patients with two or more comorbidities were consistently less likely to be within risk factor targets post CR than the no comorbidity group. The scale of influence from comorbidities was large with a 27% greater likelihood of smoking post CR when factoring in confounders such as age, gender. Conclusion: These findings are novel and important for clinicians as they show positive trends in the acceptance of patients with multimorbidity to CR. However, our findings indicate that this multimorbid patient population may require more tailoring of the CR intervention if they are to derive comparable benefits to those patients with less or no co-morbidity.

14 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 1; Thursday 11.10 – 11.35

Dr Shuli Levi Coal-Face Cardiogeriatrics: Optimising Multimorbidity in Acute Cardiology Patients

Shuli is a consultant Geriatrician and general physician, based at the Hammersmith hospital, Imperial college healthcare NHS Trust, London. She qualified from Royal Free and University College medical school in 2004 and completed MRCP in 2007. She undertook speciality training in Geriatrics /GIM NW London from 2008-2016, since when she has worked as a CardioGeriatrician, running an integrated liaison service within Imperial’s cardiology unit. Within this she has a special interest in heart failure; she also provides renal and haematology liaison on site. Other roles include training and education and BGS Ethics and Law lead.

Coal-Face Cardiogeriatrics: Optimising Multimorbidity in Acute Cardiology Patients Managing older patients with cardiac disease is an increasingly complex job – people are living longer, becoming frailer and with more co-morbidities, but with greater access to treatments and minimally invasive technologies. Supporting patients and their single organ specialists through this requires a multi-disciplinary, individualised approach with core principles of Geriatric medicine embedded in day to day Cardiology practice (and vice versa). This talk will look at components of the integrated service at Imperial NHS Trust to illustrate how this can work and focus on the specific interventions that can improve quality of care and maintain patient flow.

‘Cardiovascular Disease and Multimorbidity’ 15 Main Conference Sessions Speakers Session 1; Thursday 11.35 – 12.00

Dr Malcolm Walker The Role of Exercise Therapy in Cardio-Oncology

I trained in cardiology at St Thomas’ Hospital London, then Oxford before being appointed as Consultant Cardiologist at University College Hospital London (UCLH). In 1990 I founded the Hatter Cardiovascular Institute at UCLH, utilising donations from a Charitable Trust. This Institute moved into a bespoke building in 2006, where clinical service and laboratory cardiovascular research are housed in close physical proximity, to realize the ambition of effective research translating into patient benefit. I was a member of Council then the president for the British Association of Cardiovascular Prevention and Rehabilitation between 1999 and 2006 and served on the Council of the British Cardiovascular Society. In recent years I have ceased cardiology interventional practice to focus on developing my research interests in the cardiovascular complications of inherited diseases of the blood, where I am an acknowledged International expert. In 2016 I established the Cardio-oncology service at UCLH to serve the increasing population of cancer patients with cardiovascular complications. I have published over 100 articles in major scientific journals & have a Scopus H-index of 36.

The Role of Exercise Therapy in Cardio-Oncology New treatments have improved outcomes in many cancers, leading to an increase the numbers of survivors. As a consequence, there has been an increase of cardiovascular complications, many of which can be attributed to the very treatment that has allowed patients to expect to live beyond their cancer. This is thought to be either due to direct cardiotoxicity by chemotherapy agents, the effects of radiotherapy or by accelerating cardiovascular disease progression in susceptible individuals. The realisation that a history of cancer may be associated with cardiovascular risks, sometimes many years after the index event, has led to the emergence of a new sub- specialty in cardiology, termed “cardio-oncology” to deal with the complex clinical issues involved and maximise good quality survival after cancer. There is much to be learnt in this new area of medicine, but lessons gained from other areas of chronic disease management can be usefully applied in the case of cancer survivorship. Included in this potential therapeutic area is an emerging role for exercise and rehabilitation, which I hope to address in this presentation.

16 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 1; Thursday 12.00 – 12.25

Dr Nicola Guess Dietary Management of Type 2 Diabetes: Myths and Facts?

Nicola Guess RD MPH PhD is a Senior Lecturer at the University of Westminster, a Research Fellow at Kind’s College London and Head of Nutrition at the Dasman Diabetes Institute in Kuwait City. Her primary research interests are in the effect of foods and nutrients on the pathophysiology of type 2 diabetes. She is currently principal investigator of a number of trials looking at the effect of low-carbohydrate and high protein diets on glycaemic control in patients with type 2 diabetes. She was a National Institute of Clinical Excellence (NICE) Scholar, an Expert Advisor for the NICE Centre of Guidelines and a Winston Churchill Travel Fellow and Diabetes UK Research Fellow. She currently sits on the Diabetes UK Clinical Guidelines Committee which (alongside lay members) sets priorities for diabetes research in the UK. She is also a panel member of the Royal College of General Practitioners Lifestyle Group and was previously a topic expert on the NICE Guidelines Committee for the Prevention of Type 2 Diabetes

Dietary Management of Type 2 Diabetes: Myths and Facts? This session will cover the rationale for dietary management of type 2 diabetes, and provide an update of the evidence for low-carbohydrate, low-fat, Mediterranean and other diets. Consideration will be given to the quality of evidence behind the recommendations, what research questions remain unanswered and what advice we can give to patients in the meantime!

‘Cardiovascular Disease and Multimorbidity’ 17 Main Conference Sessions Speakers Session 2; Thursday 13.40 – 14.05

Dr Simon Williams Heart Failure Update 2019

Simon Williams is a Consultant Cardiologist at Wythenshawe Hospital, South Manchester. He specialises in all aspects of heart failure from community clinics, pacing therapy, inpatient MDT work and advanced heart failure therapies. Dr Williams is also an honorary senior lecturer at the University of Manchester where he and his mates write articles for magazines from time to time (over 120 publications in peer reviewed journals). He is Chair Elect of the British Society for Heart Failure (BSH) (having previously held all positions on the board since 2011). Simon lives in Cheshire’s golden triangle with his long suffering wife and 2 kids. He supports Altrincham FC, likes running, skiing and Coronation Street.

Heart Failure Update 2019 An update in heart failure will be presented. This will include a review of the new NICE guidelines, the NCEPOD report into acute heart failure and the most relevant recent trials.

18 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 2; Thursday 14.05 – 14.30

Professor Jamie Waterall Saving Heart and Minds Together: New CVD Prevention Ambitions for England

Professor Waterall has had a varied clinical, managerial and academic background, spanning local, regional and national roles within the health and care system in England. He is currently Deputy Chief Nurse and National Lead for Cardiovascular Disease Prevention at Public Health England. He leads several national programmes such as the NHS Health Check, CVD prevention ambitions and All Our Health. Professor Waterall also holds an Honorary Professor position at the University of Nottingham, where he first trained to be a nurse.

Saving Heart and Minds Together: New CVD Prevention Ambitions for England Although Cardiovascular Disease (CVD) mortality rates have almost halved over recent decades, there is no room for complacency in the efforts required to address the major challenges that CVD continues to play in individual lives, communities and society as a whole. Professor Waterall will present England’s very first secondary prevention ambitions for CVD which hold the potential to prevent 150,000 heart attacks, strokes and dementia cases over the next ten years. Focusing on the ABC’s for prevention, this session will detail plans to improve the prevention, early diagnosis and management for this leading cause of death and ill health.

‘Cardiovascular Disease and Multimorbidity’ 19 Main Conference Sessions Speakers Session 3; Thursday 15.45 – 16.10

Dr Ali Khavandi Cardiologist’s Kitchen

Dr Ali Khavandi is a Consultant Interventional Cardiologist at the Royal United Hospital Bath NHS Foundation Trust and medical lead for Virgin Care B&NES. He specialises in complex angioplasty and advanced cardiac rhythm device implantation. More unusually for a procedural enthusiast, Ali has a particular interest in cardiovascular prevention and management through dietary and exercise interventions.

Cardiologist’s Kitchen Dietary and exercise interventions are currently the biggest opportunity for positive change in cardiovascular medicine. How can we maximise this opportunity? A reflection on the scale of the problem, the challenges and the possible solutions.

20 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 3; Thursday 16.10 – 16.35

Professor Costas Karageorghis Groove Is In The Heart: Optimising Music Applications in Cardiac Rehab

Professor Costas Karageorghis is a Chartered Sport and Exercise Psychologist (British Psychological Society), Chartered Scientist (Science Council) and Fellow of the British Association of Sport and Exercise Sciences. His scientific output includes 200 scholarly articles, 12 chapters in edited texts and the text Inside Sport Psychology, which has been translated into Polish, Turkish and Farsi. He has recently published a second text, Applying Music in Exercise and Sport, as well as an associated study guide. Most of Costas’s scientific work has been focused on the psychological, psychophysical and neurophysiological effects of auditory and visual stimuli during exercise. He is presently Divisional Lead for Sport, Health and Exercise Sciences in the Department of Life Sciences at Brunel University London. In his spare time, Costas plays piano in the BASES Band, alongside trumpeter Professor John Buckley and vocalist Dr Emma Kavanagh.

Groove Is In The Heart: Optimising Music Applications in Cardiac Rehab From the dawn of human civilization, ancient cultures sought to combine sounds in a manner that influenced the human psyche. Given recent advances in digital technologies, music applications have become de rigueur in the realm of exercise and physical activity. The speaker will explore the structured and systematic use of music as a means by which to improve the exercise experience and thus, ultimately, to promote exercise adherence/enhance public health. A theoretical model (Karageorghis, 2016) will serve as the lodestar for a series of empirical studies and associated music-related applications. In terms of an underlying structure, music-related interventions can be applied in three key ways: pre-task, in-task and post-task. Music can be used pre-task as a tool with which to manipulate psychological state; most often as a mild stimulant. It can be used in-task, either synchronously or asynchronously, with the synchronous application holding particular benefits in terms of facilitating endurance-type performance. The post-task application of music is still at a nascent stage in research terms; nonetheless, initial evidence shows some positive signs in terms of how music can expedite exercise recovery. Particular emphasis will be placed on a body of work that has addressed the relationship between working heart rate and preference for music tempo.

Recommended reading: Karageorghis, C. I. (2017). Applying music in exercise and sport. Champaign, IL: Human Kinetics. Twitter: @SAVIBrunel

‘Cardiovascular Disease and Multimorbidity’ 21 Main Conference Sessions Speakers Session 3; Thursday 16.35 – 17.20

Dr Joseph Mills Interactive Case Studies in Cardiac Rehabilitation

I graduated from Cambridge University with a First Class honors degree in Medicine/ Economics in 1992, completed medical training in Cambridge & East Anglia in 1994 and was a British Heart Foundation junior research fellow from 1998 to 2001. I have been a consultant cardiologist at Liverpool Heart & Chest Hospital NHS FT since February 2007. My professional interests include cardiovascular disease prevention & rehabilitation (and its promotion), PCI (I am one of 12 consultants providing acute/emergency interventions for acute coronary syndromes and developing community CVD services – for which I am the clinical lead. I am ALS medical director for my Trust, cardiac lead for the Cheshire & Merseyside Strategic Clinical Network and immediate Past-President of the British Association for Cardiovascular Prevention & Rehabilitation. I am the CVD prevention coordinator for the UK which is a BCS/ESC role. I am passionate about education and have been involved in developing pathways for improved AF management, on-line educational tools for primary care and face-to-face services to assist with difficult anticoagulation decisions. My research interests are centered around promoting cardiac rehabilitation, particularly after cardiac surgery and for patients with heart failure and the facilitation of all aspects of CVD prevention.

22 BACPR Annual Conference 2019 Interactive Case Studies in Cardiac Rehabilitation MDT Panel

Brian Begg

Brian is a Sport and Exercise Science graduate from the University of Limerick (Ireland) who has worked in Cardiac Rehabilitation since 2005. He qualified as a BACPR Instructor in the same year and more recently was accepted as a BASES Certified Exercise Practitioner. Brian currently works for the Cardiac Rehabilitation team of Aneurin Bevan Health Board (South East Wales) and the Countryside Service of Caerphilly County Borough Council in an innovative partnership post. For the first time in Wales a post exists that has a direct link between Health and the Environment. Brian is responsible for delivering the exercise component of acute cardiac rehab and for developing ongoing physical activity opportunities (walking groups and maintenance classes (phase IV)). Brian is the past chair of the BACPR Exercise Professionals Group and the BACPR Exercise Instructor Network. Brian is currently the Principal Investigator of the HIIT (High Intensity Interval Training) MISS (Moderate Intensity Steady State)UK trial, whilst undertaking an MPhil/PHD with Cardiff Metropolitan University. Brian indulges his love of potatoes by spending many an hour in the garden cultivating the finest Irish Spuds in Wales.

Dr Carolyn Deighan

Dr Carolyn Deighan, C Psychol is a chartered health psychologist for the Heart Manual Department, NHS Lothian leading the psychology input into the facilitated resources and associated clinician training in the UK and internationally. Academic roles include lecturer in health psychology at Queen Margaret and Heriot-Watt universities, Edinburgh. She is a regular guest lecturer at the Institute of Sports and Exercise, University of Edinburgh. Carolyn was principle investigator for the Digital Heart Manual evaluation with the Centre for Population Sciences, University of Edinburgh. She has collaborated in the development of new rehabilitation interventions and training in heart failure (Heart Cycle EU and REACH-HF) and cancer (the Cancer Manual). She is a committee member for the British Psychological Society, Division of Health Psychology, Scotland. Carolyn was involved in the writing of the BACPR Core Competences in Education and Health Behaviour Change and is the lead for the BACPR online training modules in Health Behaviour Change and Psychosocial Health. Carolyn joined BACPR council in December 2016 and was re-elected in 2018.

‘Cardiovascular Disease and Multimorbidity’ 23 Interactive Case Studies in Cardiac Rehabilitation MDT Panel

Alison Allen

Alison spent several years working in the field of coronary care before specialising in Cardiac rehabilitation in 1994. She is now clinical lead for the Cardiac Rehabilitation Service in Cwm Taf Morgannwg University Health Board. The team delivers cardiac rehab across a range of settings from 3 District General hospital sites into Primary and community venues throughout South Wales including Merthyr Tydfil, Rhondda and the Bridgend Valleys. She feels privileged to have been given the opportunity to shape and develop rehabilitation and support services in areas with some of the highest rates of heart disease and deprivation in the UK. This sets us a very challenging but hugely rewarding task in delivering multi-disciplinary rehabilitation to over 900 patients per year. Her passion for Cardiac rehabilitation and prevention has continued for over 25 years. She has been an integral member of the All Wales Cardiac Rehabilitation and Heart Failure working group whose key objective is to support, drive quality and work collaboratively to improve services across Wales. She continues to be an active member of the NACR steering group having been an early adopter of the audit since the mid 1990’s. Her professional interests include Heart failure, Health promotion and Health behaviour change.

Dr Tom Butler

Tom in a senior lecturer in Nutrition and Dietetics at the University of Chester. Tom completed his PhD in 2012, examining the role of dietary fat and carbohydrate on cardiac functional and metabolic remodelling in response to hypertension and obesity. He is a HCPC registered dietitian and registered nutritionist with the Association of Nutrition. Tom is the lead for the BACPR diet working group.

24 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 6; Friday 10.50 – 11.00

Dr Tom Butler Update from BACPR Diet Working Group

Update from BACPR Diet Working Group Nutrition is a fundamental component of primary and secondary prevention of CVD. However the field of nutrition has been plagued by conflicting studies and has focussed on single food components, ignoring the fact that individuals consume whole foods. Clinical guidelines continue to reinforce this and lack flexibility that current evidence suggests is beneficial for improving CV health. To tackle this the BACPR established the Diet Working Group. The group has been working towards a publication aiming to shed light on some of the key controversies related to diet and CVD, as well as identify areas for future development and research. In this session Dr Tom Butler (lead for the group) will provide an overview of progress to date and outline plans for future publications.

‘Cardiovascular Disease and Multimorbidity’ 25 Main Conference Sessions Speakers Session 6; Friday 11.00 – 11.15

Dr Thomas Heseltine HDL, LDL and Triglycerides: The Good, the Bad and the Ugly Dr Thomas Heseltine is a PhD fellow and acting Consultant Cardiologist based at the University of Liverpool and Royal Liverpool University Hospital. His research interests include HIV and cardiovascular disease, cardio-metabolic syndrome and cardiac cross sectional imaging. He is currently researching the impact of antiretroviral therapy on lipids, insulin resistance and coronary plaque.

HDL, LDL and Triglycerides: The Good, the Bad and the Ugly Routine measurement of lipoproteins remains the cornerstone of cardiovascular disease (CVD) risk prediction and secondary prevention. Reduction of low-density lipoprotein (LDL-C) by pharmaceutical therapy and lifestyle modification is recommended to varying levels depending on an individual’s CVD risk. Despite a collective all-time low level of cholesterol and lower rates of smoking the incidence of CVD has recently risen in western countries. Within this review we will discuss the physiology of the bodies energy transfer system and how pathological changes within this may drive CVD risk. In addition, we will analyse the impact of insulin resistance and how this may represent a missing link in CVD risk.

26 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 6; Friday 11.15 – 11.40

Dr Rani Khatib Integrating Pharmacy into Cardiac Rehabilitation Dr Rani Khatib is a Consultant Pharmacist in Cardiology & Cardiovascular Research at the Leeds Teaching Hospitals NHS Trust. Honorary Senior Lecturer at the Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds. Leads on the delivery of several innovative cardiology medicines & risk optimisation clinics including: the Post-MI medicines optimisation Service, the PCSK9 inhibitors and statins intolerance service, the Heart Failure Medicines Optimisation Virtual Clinic, and the anitplatelets 12-months virtual review clinic. NICE HF Guidelines Committee member. Chair of the UKCPA Cardiology Group. European Society of Cardiology ACNAP Science Committee Member. Well published with specific interest in medicines adherence, person-centred care and cardiometabolic medicines and risk optimisation. Earned multiple recognitions and awards for innovation and excellence in patient care. Full details are here: medicinehealth.leeds.ac.uk/medicine/staff/507/rani-khatib

Integrating Pharmacy into Cardiac Rehabilitation The success in preventing and reducing the burden of cardiovascular disease requires the delivery of a person-centred primary and secondary prevention initiatives based on a collaborative approach between the diverse healthcare professionals in the healthcare continuum. In this session we will shed light on the role that the pharmacy profession can play in supporting the cardiovascular disease prevention agenda with specific focus on the cardiac rehabilitation pathway. Community, GP based, and hospital pharmacy teams have key roles to play in supporting patients with cardiovascular disease. These will be explored and examples of successful initiatives will be shared.

‘Cardiovascular Disease and Multimorbidity’ 27 Main Conference Sessions Speakers Session 6; Friday 11.40 – 12.00

Dr Vicky Pettemerides Combining Prevention and Rehabilitation with Cardiology Sub-Specialisation – What are the barriers to change? Victoria has recently completed a fellowship in Advanced Echocardiography and Inherited Cardiac Conditions at Wythenshawe Hospital and will soon be taking up a consultant post at Liverpool Heart and Chest Hospital. She graduated from University College London in 2006 and following Foundation Training in London completed her postgraduate training in Cardiology in North West Deanery. Throughout her training, Victoria has developed interests in imaging, heart muscle disease, valve disease and sports cardiology. She is currently taking a MSc in Sports Cardiology at St Georges University London and is passionate about promoting safe physical activity in patients with a range of cardiovascular disorders.

Combining Prevention and Rehabilitation with Cardiology Sub-Specialisation – What are the barriers to change? Many Cardiologists will leave training without a true understanding of cardiac rehab programmes, or an ability to provide preventative strategies to patients with cardiovascular disease. This is despite it being embedded in management guidelines and being a core competency required for the completion of training. Clinician involvement and endorsement plays a key role in patient uptake and adherence of cardiac rehabilitation and in promoting behaviour change, but interest and training in this area is extremely variable. This session will explore the reasons why this may be and discuss the potential barriers to change.

28 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 6; Friday 12.00 – 12.25

Sally Hughes Reimagining Cardiac Rehabilitation Services – Ambitions and Opportunities Sally Hughes is Head of Health Services Engagement at the British Heart Foundation and leads a UK wide team focused on engagement with senior decision makers across national and local health economies to improve outcomes for people living with Cardiovascular Disease (CVD). She is on the Board of Trustees at National Voices – a coalition of charities that stands for people being in control of their health and care. Sally has held experience held a variety of senior roles across strategic planning, service improvement and commissioning in the NHS, Local Government and the charitable sector which includes work at a local, regional, UK wide and international level.

Reimagining Cardiac Rehabilitation Services – Ambitions and Opportunities In November 2018 British Heart Foundation published ‘Turning Back the Tide’, our framework for beating the heartbreak of Heart and Circulatory Diseases, and called for rehabilitation services to be reimagined. Following that in January 2019 the NHS Long Term plan was published in England with Cardiovascular Disease and cardiac rehabilitation being confirmed as major national priority. The British Heart Foundation is working in partnership to support these plans, as well as major initiatives in Scotland, Wales and Northern Ireland. How can data support our plans to improve quality and innovate to improve outcomes for patients? How can more personalised recovery services be part of our future plans? What is the role of digital? Hear from the BHF’s Head of Health Services Engagement, Sally Hughes about the current strategic initiatives being supported by BHF across the UK and what we need to do next to achieve our collective ambitions and plans.

‘Cardiovascular Disease and Multimorbidity’ 29 Main Conference Sessions Speakers Session 7; Friday 13.35 – 14.00

Professor Sally Singh Breathlessness in COPD and Chronic Heart Failure Sally Singh is a Professor of Pulmonary & Cardiac Rehabilitation at the University of Leicester, working at the University Hospitals of Leicester NHS Trust. She has many years of experience developing pulmonary and cardiac rehabilitation services. She is the current national Clinical lead for pulmonary rehabilitation the National Asthma and COPD Audit Programme and the clinical lead for the RCP Pulmonary Rehabilitation Services Accreditation Scheme. She has worked as part of the clinical teams to develop and evaluate a number of novel interventions for cardiac and respiratory patients, including web based interventions and the breathlessness programme.

Breathlessness in COPD and Chronic Heart Failure Breathlessness is a common and important manifestation of both chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD), indeed it is a frequent co-morbidity of either the index respiratory or cardiac disease. We have previously reported that individuals with CHF can be successfully integrated into a pulmonary rehabilitation programme (Evans R et al 2010). The breathlessness service has developed this concept further and not only integrated the respective participants but also the staff involved in the delivery of cardiac and pulmonary rehabilitation to maximise the experience for the patient. This talk will describe the process and outcomes to date of the breathlessness rehabilitation programme in Leicester.

30 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 7; Friday 14.00 – 14.20

Dr Helen Speake Designing Interventions for Multimorbid Populations: Involving the End user

Dr Helen Speake is a researcher in physical activity, health and user-centred design from the Faculty of Health and Wellbeing, Sheffield Hallam University. Helen specialises in participatory research approaches that engage patients, professional stakeholders and members of the public in research and intervention planning, including a range of qualitative methods and co-design. She is currently leading the development of NHS physical activity pathways across South Yorkshire and the co-design of multimodal lifestyle interventions for people living with long-term conditions including coronary heart disease, cancer, musculoskeletal conditions, HIV and obesity. Helen also works on community asset- based projects including the design of young people’s sexual health services. She recently contributed to the Faculty of Sport and Exercise Medicine and Public Health England’s ‘Moving Medicine’ programme as a member of their expert advisory group.

Designing Interventions for Multimorbid Populations: Involving the End user In 2019 there is increasing recognition and expectation that to be effective, public health interventions should be developed not just for, but with, the people for whom they are intended. The “co-design” of these interventions brings with it both benefits and challenges, particularly in healthcare settings such as the NHS. Dr Helen Speake will discuss the realities of user involvement using applied examples from projects involving multimorbid populations and reflect on the current and future evidence base for these approaches.

‘Cardiovascular Disease and Multimorbidity’ 31 Main Conference Sessions Speakers Session 7; Friday 14.20 – 14.40

Dr Coral Hanson Exercise Referral Schemes - Access, Adherence and Multimorbidity Dr Coral Hanson has worked as a research fellow in the School of Health and Social Care at Edinburgh Napier University since January 2017. Prior to this, she spent 20 years working in the public leisure sector environment and has been involved in tutoring for the BACPR exercise instructor course since 2002. Her research has mainly focused on factors influencing participation in physical activity interventions for those with non-communicable diseases and resultant changes in physical activity behaviour. She is currently involved in several research projects; a mixed methods project examining how gender affects participation in physical activity interventions; the development and evaluation of a physical activity mobile health app to support participants in an exercise referral scheme and a feasibility randomized controlled trial aimed at increasing medication adherence among adults with atrial fibrillation using mobile health technology. Exercise Referral Schemes - Access, Adherence and Multimorbidity Background: Exercise referral schemes (ERS) are internationally widespread and may include participants who have completed cardiac rehabilitation. This study is part of a larger project examining uptake and adherence to a Scottish ERS and exploring factors affecting engagement. Method: Participants took part in telephone interviews (pre-scheme and after 12 weeks), which included demographic, health, and closed and open questions about engagement. Statistical analyses examined predictors of uptake and adherence. Thematic analysis was used to analyse open responses. Preliminary results: 136 participants completed baseline interviews and 120 (88%) completed 12- week interviews. 126 (93%) had at least one comorbidity (median 3 IQR 2-4). Uptake (those attending at least one session) was 73.5% (n=100). For those who started, adherence (attended 8 out of 12 sessions) was 59% (n=59). There was no significant differences in uptake or adherence due to number of comorbidities. Participants reported that enjoyment, staff and social support were important facilitators of adherence. Lack of communication, ill health, inappropriate activities/activity level and holidays were reported as reasons for non-engagement and dropout. Conclusion: In order to encourage uptake and adherence, ERS should focus on good communication, providing appropriate activities, social support and develop strategies to re-engage participants after episodes of ill health/holidays .

32 BACPR Annual Conference 2019 Main Conference Sessions Speakers Session 7; Friday 14.40 – 15.00

Dr Aynsley Cowie Delivering a Specialist – Generalist Rehabilitation Model in Practice Based within NHS Ayrshire & Arran, Aynsley is a consultant physiotherapist in cardiology. Within this post she led on a Scottish Government funded research project to develop and pilot a new patient-reported outcome measure for cardiac rehabilitation, and has been co- ordinating evaluation of the healthy and active multimorbidity rehabilitation programme (HARP) [see below]. Aynsley has a PhD in (home-versus centre-based) exercise training in heart failure, and continues to work to further develop exercise training and physical activity options and pathways for this group. She is about to start a qualitative project examining exercise perceptions in inherited cardiac conditions. Aynsley is Research Officer for the Association of Chartered Physiotherapists in Cardiac Rehabilitation (ACPICR). She has been on the BACPR council since December 2014, undertaking the role of Scientific Officer until October 2018. Aynsley regularly teaches on the BACPR/ACPICR Physical Activity in Heart Failure course.

Delivering a Specialist – Generalist Rehabilitation Model in Practice Within Ayrshire, Scotland, the Healthy and Active Rehabilitation Programme (HARP) is a model of rehabilitation for people living with multimorbidity that was set up in 2015 by a multi-agency health and social care team. The team worked collaboratively to produce a more sustainable, generic approach to rehabilitation. HARP focuses specifically upon deprived and rural Ayrshire communities and is accessed by those with conditions that typically place high demands upon unscheduled care (cardiac or pulmonary disease, cancer, stroke, diabetes, and falls). HARP has been designed as a flexible four tiered model, with a focus upon supporting individuals to develop the confidence and capabilities to self-manage their conditions in the longer term. Service users can move between its tiers in order to access the best support to suit their changing needs. Tier Four Specialist evidence-based condition-specific rehabilitation Tier Three A new approach to rehabilitation for individuals with multiple conditions struggling to self-manage Tier Two Activities, exercise and education sessions provided by local leisure staff with specialist knowledge, qualifications and skills Tier One Access to third sector community and voluntary groups This session will describe how HARP has been implemented within Ayrshire, and the impact that this new model has had upon the existing service, upon staff, and upon its service users.

‘Cardiovascular Disease and Multimorbidity’ 33 Main Conference Sessions Speakers Session 7; Friday 15.00 – 15.25

Dr Thomas Keeble Care after Resuscitation Dr Keeble is an interventional cardiologist with a specialist research interest in cardiac arrest, and has conducted and published a number of studies in this field including targeted temperature management and neuro-prognostication. In 2013 he set up the UK’s first Care After REsuscitation (CARE) clinic in the Essex Cardiothoracic Centre in association with Anglia Ruskin University. He now understands a huge unmet need within the follow up and service provision for survivors of cardiac arrest and their families. With Prof Karen Smith he has recently founded the International Task force for Cardiac Arrest Recovery (ITCAR) to try and improve evidence and guidance for patients and deliver a better follow up and rehabilitation service for these vulnerable patients; for which cardiac rehab teams will be at the heart. He will talk about the current deficiencies in follow up, the emerging data, and a future vision for cardiac arrest recovery involving a multi-disciplinary team.

34 BACPR Annual Conference 2019 Symposia, Workshops and AGMs

Thursday 3rd October 13.00 - 13.30 Banqueting Suite The role of cardiac rehabilitation in identifying the high-risk patient for improved lipid management Speakers: Dr. Scott Murray, Consultant Cardiologist, Liverpool and Catherine McIlduff, Lead Cardiac Rehabilitation Nurse, Birmingham Heartlands Hospital. An introduction by Dr Scott Murray followed by a case study from Birmingham Heartlands Hospital on how to implement a post ACS lipid management pathway.

Supported by Sanofi

Thursday 3rd October 15.00 - 15.40 Conference Suite 2 What are the barriers to assessment? NACR Workshop 1 Thursday 3rd October 17.30 - 18.00 Conference Suite 2 BACPR AGM

Friday 4th October 12.45 - 13.15 Banqueting Suite Towards optimised models of care for post-MI patients: An interactive discussion among MDT consensus panel members This lunchtime symposium will explore opportunities for MDT members to optimise post-MI and CVD Secondary Prevention Care across the NHS. By attending, delegates will: • Gain understanding of the overlapping roles of MDT members working in CVD secondary prevention (cardiologists, GPs, specialist pharmacists, specialist nurses and others) by presenting various models of care • Recognise opportunities to improve CVD secondary prevention care through medicines optimisation and by encouraging patient activation at each step of the post-MI patient pathway • Develop confidence in promoting patient participation in comprehensive, individualised and menu-driven cardiac rehabilitation programmes that meet the BACPR standards Chair: Scott Murray Faculty: Ahmet Fuat, Jan Keenan, Rani Khatib

Supported by Astrazeneca

Friday 5th October 12.35 - 13.15 Conference Suite 2 What is completion? NACR Workshop 2

‘Cardiovascular Disease and Multimorbidity’ 35 Chairpersons

Alison Allen

Dr Aynsley Cowie

Based within NHS Ayrshire & Arran, Aynsley is a consultant physiotherapist in cardiology. Within this post she led on a Scottish Government funded research project to develop and pilot a new patient-reported outcome measure for cardiac rehabilitation, and has been co-ordinating evaluation of the healthy and active multimorbidity rehabilitation programme (HARP) [see below]. Aynsley has a PhD in (home-versus centre-based) exercise training in heart failure, and continues to work to further develop exercise training and physical activity options and pathways for this group. She is about to start a qualitative project examining exercise perceptions in inherited cardiac conditions. Aynsley is Research Officer for the Association of Chartered Physiotherapists in Cardiac Rehabilitation (ACPICR). She has been on the BACPR council since December 2014, undertaking the role of Scientific Officer until October 2018. Aynsley regularly teaches on the BACPR/ACPICR Physical Activity in Heart Failure course.

36 BACPR Annual Conference 2019 Chairpersons

Dr Hayes Dalal

Hasnain (Hayes) Dalal is a clinical researcher having worked as a GP in Truro, Cornwall for 30 years where he was inspired by a patient to find out about more about cardiac rehabilitation. Over the years, he has developed an interest in primary care cardiology and led a RCT, funded by the NHS, comparing centre vs home based cardiac rehabilitation. He is currently jointly leading the REACH HF Study – a Programme Grant for applied research from the NIHR .He is an honorary Clinical Associate Professor with the University of Exeter Medical School and an ordinary council member of the BACPR.

Professor Susan Dawkes

Dr Carolyn Deighan

‘Cardiovascular Disease and Multimorbidity’ 37 Chairpersons

Gill Farthing

Gill currently works as a Cardiac Rehabilitation Nurse Specialist at Hampshire Hospitals NHS Trust in Winchester. She has over 20 years experience in cardiovascular nursing with a particular focus on cardiac rehabilitation and prevention. She has worked in a variety of settings both in hospital and the community, and has been involved with setting up a community programme from its inception. She believes in a holistic approach to cardiac rehabilitation focusing on both the heart and mind of the individual. She joined council as an ordinary officer last year and has since taken on the role of Treasurer.

Jo Hayward Jo is the Cardiac Rehabilitation Lead at the Norfolk & Norwich University Hospital and BACPR Honorary Secretary. Whilst on council she was actively involved in updating and developing the 2017 BACPR Standards and Core Components document. Over the past 25 years she has gained a broad range of experience as a nurse in both acute cardiology and rehabilitation. She believes quality cardiac rehabilitation is central to the long-term wellbeing of our patients and should always be an integral part of their care. Jo has been involved in her regional cardiac rehabilitation alliance for many years and the experience of working across areas, with different teams and programmes, sharing best practice, has been of great benefit to evolving her service. The Norfolk & Norwich hospital is a busy heart attack centre providing rehabilitation in conjunction with the community colleagues to over 1000 patients a year. This year the programme should receive certification and Jo is aware of the work and the issues this can raise. Jo feels privileged to work with rehabilitation patients and see the dramatic changes they often make in their lives.

Sally Hinton

Sally is the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) Executive Director and Education Director responsible for supporting the BACPR executive committee across all aspects of the work of the association and responsible for the expanding education programme including the BACPR Exercise Instructor qualification, range of short courses and on line education. She is both founder chair of the ACPICR (Association of Chartered Physiotherapists interested in Cardiac Rehabilitation) and the BACPR Exercise Professionals Group committee. Sally completed an MSc in Health Promotion at Brunel University with a dissertation in patients’ compliance with exercise after cardiac rehabilitation and has many years’ experience lecturing in the field of Cardiovascular Rehabilitation. Sally was one of the authors of the BACPR Standards and Core Components for Cardiovascular Prevention and Rehabilitation (2012), a key document for the cardiac rehabilitation programmes within the UK.

38 BACPR Annual Conference 2019 Chairpersons

Sheona McHale

Sheona is a PhD researcher in physical activity within the School of Health and Social Care at Edinburgh Napier University and a BACPR Specialist Exercise Instructor delivering community based exercise cardiac rehabilitation. Previously Sheona worked as a Curriculum Head and a lecturer of fitness, health and exercise at Fife College. Currently Sheona is the founder of Inhalefitness which is a private business offering personalised training and aims to improve the fitness of others. Sheona has an interest in the physical activity behaviours of individuals diagnosed with Coronary Heart Disease and in her PhD she is using a mixed methodology to explore factors contributing to increased physical activity levels after a diagnosis of Acute Coronary Syndrome in the context of cardiac rehabilitation. So far Sheona has completed a systematic review exploring how previous experience of physical activity influences engagement with cardiac rehabilitation and the findings will be published soon. Sheona is an ordinary council member of BACPR and keen to understand the support needs of BACPR level 4 qualified exercise instructors.

Dr Simon Nichols Simon is a Senior Research Fellow in Exercise Physiology at Sheffield Hallam University. Simon worked as an exercise professional in an NHS cardiac rehabilitation service before pursuing a career in research. His research focuses on improving existing treatments and developing specialist treatments for patients with cardiovascular disease. He has a particular interest in developing interventions to treat cardiovascular disease in patients who are suffering from frailty or who have significant co-morbidities. Simon also works as a member of the National Centre for Sports and Exercise Medicine (NCSEM), an Olympic legacy project delivering research, education and clinical services in sport, exercise and physical activity. He is also the Scientific Officer for the BACPR council, President of the BSCPR Exercise Professional Group, and an Editorial Board Member for the British Journal of Cardiology.

Ceri Roberts Having previously studied Sport and Exercise Science at Pencoed College and the University of Gloucestershire Ceri then qualified as a nurse from Cardiff University and is now currently nearing completion of a Masters Degree in Cardiovascular Health and Rehabilitation at the University of Chester. He also holds certification as a qualified Level 2 Gym Instructor, Level 3 Personal Trainer and Level 4 Specialist Exercise Instructor for CVD, Diabetes and Obesity. During his career as an exercise professional and nurse he has witnessed first-hand how lifestyle is the foundation for many diseases and illnesses. Since working as a Clinical Nurse Specialist in Cardiac Rehabilitation he has been optimally placed to work with patients that require lifestyle manipulation in an attempt to manage their risk factors. This has led him to set up Clinical Health and Fitness in order to support those in the fight against ill health and hopefully stave off any chronic diseases. Ceri is also a member of the BACPR council and the lead for the communications and digital media relations. He is a keen geocacher, amateur astronomer, geologist and ultra-marathon runner.

‘Cardiovascular Disease and Multimorbidity’ 39 Oral Abstract Presentations Session 5

9.00 – 9.15 Is There A Difference In Exercise Capacity Outcomes In Heart Failure Patients With And Without Atrial Fibrillation Whilst Attending A Heart Failure Rehabilitation Programme?

N. Gardiner Cardiac Rehabilitation, University Hospitals of Leicester NHS Trust, Glenfield Hospital

Introduction The most recent Cochrane review on exercise-based rehabilitation for Heart Failure (HF) showed that rehabilitation provides important improvements in health-related quality of life. Atrial Fibrillation (AF) and HF are common cardiovascular conditions which share similar risk factors and pathophysiology. HF Rehabilitation promotes management of modifiable risk factors associated with AF; however, there is little evidence with regards to treated AF and exercise outcomes in this population.

Aim To identify whether there are any differences in exercise outcomes and comorbidities between patients with treated AF and sinus rhythm (SR), following a HF rehabilitation programme.

Methods We collected and analysed baseline characteristics and pre-post exercise capacity (Incremental Shuttle Walking Test; ISWT) and endurance (Endurance Shuttle Walking Test; ESWT) data for patients who attended an 8-week HF rehabilitation programme. Pre-post comparisons were examined using two-way analysis of covariance.

Results Fifty patients with treated AF (n=26) and sinus rhythm (n=24) took part. At baseline, patients with treated AF were older than those with SR and there was no difference in the prevalence of comorbidities and exercise capacity (Table 1). Exercise capacity improved for both groups (p=0.011) and to a similar extent following HF rehabilitation (e.g. AF: ISWT ∆54.2m (SD 49.5m); SR: ISWT ∆66.7m (SD 82.4m), p=0.836) (Table 2).

Conclusion Although this is a small study, results indicate that there are no differences in exercise outcomes for patients with treated AF compared to those in sinus rhythm. Further research would be useful to explore the modifiable risk factors in more detail.

40 BACPR Annual Conference 2019 Oral Abstract Presentations Session 5

9.15 – 9.30 Do Comorbidities Determine The Improvement In Depression In Patients With New Onset Depressive Symptoms Following Cardiac Rehabilitation?

S. Sever University of York

Introduction Due to the increasing life expectancy of older adults, there has been an increase in chronic conditions which may have an impact on their psychosocial health. This study aims to investigate whether comorbid conditions in patients with new onset depressive symptoms determine change in their depression following cardiac rehabilitation (CR).

Methods Analysing the routine practice data of British Heart Foundation (BHF) National Audit of Cardiac Rehabilitation (NACR) from the last six years between April 2012 and March 2018, an observational study has been conducted. Patients with new onset post heart event depressive symptoms and no previous documented history of depression constituted the study population. An independent samples t-test and chi-square test were used to examine the baseline characteristics followed by a binary logistic regression analysis to predict the change in Hospital Anxiety and Depression Scale (HADS) depression outcome.

Results The analyses included 64,658 CR patients with new onset depressive symptoms. The determinants of improved depression outcomes after CR were not having the following comorbidities: angina (OR: 1.239, 95%CI: 1.106 to 1.389), diabetes (OR: 1.223, 95%CI: 1.103 to 1.355), stroke (OR: 1.351, 95%CI: 1.127 to 1.620), emphysema (OR: 1.518, 95%CI: 1.157 to 1.994), and chronic back problems (OR: 1.216, 95%CI: 1.064 to 1.389). In addition, higher total number of comorbidities and being in the most socially deprived areas were associated with reduced odds of improvement (OR: 0.946, 95%CI: 0.915 to 0.979 and OR: 0.780, 95%CI: 0.694 to 0.876 respectively).

Conclusion Baseline comorbid conditions of patients with new onset depressive symptoms were negative predictors of change in depression. In patients with new onset depressive symptoms programmes should try to focus on tailoring CR to comorbidities associated with poorer outcomes.

‘Cardiovascular Disease and Multimorbidity’ 41 Oral Abstract Presentations Session 5

9.30 – 9.45 What Works For Supporting Health Behaviour Change In Cardiovascular Health Promotion? Findings From A Recent ‘State Of The Art’ Review

C. Greaves University of Birmingham

Objective This study aimed to analyze the most up-to-date evidence on interventions that are effective for changing diet and physical activity to manage elevated blood sugar (diabetes or pre-diabetes) and also to manage cardiovascular risk.

Methods To inform our systematic review of reviews, we conducted systematic literature searches of published systematic reviews. We summarised the most recent evidence (published between January 1, 2016, and December 31, 2017) and integrated this with pre-existing guidance) on intervention components associated with effectiveness. Studies were quality-assessed using the Overview Quality Assessment Questionnaire and only high quality reviews were included. Evidence was extracted using a pre-defined template and narratively synthesized by intervention type and outcomes.

Results The searches identified 861 papers and 24 studies were included, containing 95 analyses relating intervention components to effectiveness and 19 effectiveness analyses. The included systematic reviews were of good to very good quality (median OQAQ score = 16). The findings reinforce existing guidance on supporting changes in diet and physical activity and generated new evidence based recommendations. Interventions including theory, direct meal-provision, including a dietitian and the use of digital platforms (especially ‘blended care’ interventions) as an optional or additional delivery mode were associated with increased effectiveness. There is also a need for high quality delivery of complex behavioural interventions.

Conclusions Recommendations for effective intervention and service development/training described here should be adopted into evidence-based practice guidelines for the prevention of cardiovascular disease. It may be possible to integrate cardiovascular and diabetes prevention services.

42 BACPR Annual Conference 2019 Oral Abstract Presentations Session 5

9.45 – 10.00 Cardiovascular And Cardiorespiratory Adaptations To Routine Exercise-Based Cardiac Rehabilitation (CARE CR): A Community-Based Controlled Study With Criterion Methods In The United Kingdom

S. Nichols Centre for Sport and Exercise Science, Sheffield Hallam University

Background The aim of this controlled study was to assess the short- (10 weeks) and longer-term (12 months) effects of a United Kingdom (UK)-based cardiac rehabilitation (CR) programme on markers of cardiovascular and cardiometabolic health, using criterion methods.

Methods Patients with a recent diagnosis of coronary heart disease were recruited. Patients were free to participate in a physiotherapist-led, eight week, 16 session personalised CR programme (intervention group), or were free to abstain from supervised exercise (control group). A range of measurements were made prior to, and following exercise training (or 10 weeks after baseline assessment for controls), and after 12 months. These included a maximal cardiopulmonary exercise test, and a Calibre 5-year all-cause mortality risk score.

Results We recruited 48 patients to the intervention group, and n=22 acted as controls (combined age 63.1 ± 10.0 years; BMI 29.2 ± 4.0 kg.m−2; 86% male). Exercise training duration increased from 12 minutes at exercise session 1 (range: 4 to 28 minutes), to 23 minutes at their final exercise session (range: 11 to 50 minutes; p<0.001). The mean exercise intensity was prescribed at 49.9% of a patients HRR (95% CI: 39.9 to 51.8 %), or 104% of the ventilatory anaerobic threshold (95% CI: 98.6 to 109.3%). There was no change in V O2peak or all-cause mortality risk in either group.

Conclusion . Increasing VO2peak can improve survival in patients. with coronary heart disease. Current exercise training provision in CR may not lead to a significant improvement in VO2peak, which may partly explain why CR no-longer appears to improve survival.

‘Cardiovascular Disease and Multimorbidity’ 43 Oral Abstract Presentations Session 5

10.00 – 10.15 Understanding The Facilitators And Barriers To Exercise After Stroke Among Patients, Exercise Professionals And Clinicians

B. Moyle Sheffield Teaching Hospitals Foundation NHS Trust . University of Sheffield

Introduction Exercise programmes after stroke improve walking, balance, and cardiovascular risk profiles. Uptake into such programmes, if offered, is however low. We sought to explore facilitators and barriers to exercise participation, among patients, exercise professionals and healthcare clinicians.

Methods Semi-structured, qualitative interviews were conducted with 17 patients suffering stroke or transient ischaemic attack (TIA), 6 healthcare professionals specialising in stroke, and 2 exercise professionals running stroke specific exercise programmes. Interviews were audio recorded, transcribed verbatim, coded and analysed using thematic analysis. Comparisons of themes according to group interviewed were explored.

Results Patients interviewed were predominantly male (n=13, 77%), mean (SD) age of 67 (8.9) years, and were an average of 2.4 years post stroke (n=15, 88%) or TIA event. Eleven (65%) had completed an exercise programme, 5 (30%) were non- completers, and 1 (5%) had refused exercise. Exercise professionals were experienced (> 5 years working with stroke), clinicians included 5 doctors and 1 physiotherapist. Across all groups the three most consistently reported facilitators to participation included social support networks, physical and emotional benefits. While practical (transport, family or carer availability) and financial barriers were most commonly reported from patients and exercise professionals, neurological impairment, comorbid disease and low motivation was most consistently reported by clinicians. Interestingly, clinicians were more likely to report barriers than facilitators compared to patients and exercise professionals.

Conclusion A mismatch in perceived barriers to exercise between patients and healthcare clinicians may impact negatively on referral rates and exercise uptake after stroke and TIA.

44 BACPR Annual Conference 2019 Moderated Posters

M1. The Development Of A Group Education Programme With Subsequent Text-Message Support Designed To Increase Physical Activity In Individuals With Diagnosed Coronary Heart Disease - Physical Activity After Cardiac Events (PACES) L. Herring, H. Dallosso, S. Schreder, M. Davies Leicester General Hospital

M2. Evaluation Of Cardiac Rehabilitation Dose On Physical Fitness J. Leader, P. Doherty, A. Harrison University of York

M3. REACH-HF Beacon Site Project: Developing And Evaluating A Network Of Practice For The Implementation Of Home-Based Heart Failure Rehabilitation Across The UK S. Van Beurden, P. Daw, H. Dalal, S. McDonagh, C. Greaves, P. Doherty, R. Taylor Royal Cornwall Hospitals Trust

M4. Does Functional Limitation Profile Questionnaire Score Correlate To Predicted MET Max Achieve During A Functional Capacity Test? N. Graham, L. Smith, T. Grove, N. Harris, N. Lockyer Imperial Cardiovascular Health Service

M5. Arteriograph – A Simple, User-Independent Device To Determine Arterial Stiffness And Improve Risk Stratification M. Illyes, Z. Lenkey, I. Horvath, F. Molnar, S. Vafaei, A. Cziraki A Tensiomed

‘Cardiovascular Disease and Multimorbidity’ 45 Posters

1. Active+: Community-based rehabilitation and digital self-care to increase Patient Activation by 15%. K. Auton, S. Nolasco, D. Lander Peadon J Aseptika Ltd (Activ8rlives)

2. Do Cardiac Rehabilitation Patients in Newcastle Upon Tyne hospitals exercise within their training heart rate ranges as recommended by the British Association For Cardiac Rehabilitation guidelines? P. McCallion, G. Snelson, W. Duff, S.Carrol, L. Llewellyn Newcastle Upon Tyne Hospitals NHS Foundation Trust

3. The effects of a novel four pillar approach to rehabilitation following Coronary Artery Bypass Graft (CABG) S. Olden, I. Cradock, G. Kandola, Q. Barter. Clinical Prevention and Rehabilitation Ltd

4. Frequency of peripheral arterial disease in patients presenting to rheumatology clinic at a tertiary-care hospital M. Nadeem, S Iftikhar , L Abbasi , S Ahmed, M Devi, M J Patel Indus Hospital, Karachi, Pakistan

5. Our Ageing Population: Aqua and functional classes improve patient uptake and adherence in Cardiac Rehabilitation E. Tye, S. Jones, S. Lockett, C. Gilchrist, A. Turner University Hospital of North Midlands NHS Trust

6. The effect of cardiac rehabilitation on balance ability in cardiac patients N. Karachle, A. Darby, A. Swan CUH Addenbrooke’s Hospital

7. An exploration of the uptake of and adherence to a UK cardiac rehabilitation programme – taking an ethnographic approach J. Blackwell, J. Allen-Collinson, A.B. Evans, H. E. Henderson University of Lincoln and University of Copenhagen

8. Integrated qigong for cardiac health - A project to introduce qigong in a local Cardiac Rehabilitation setting T. Alabaster, J. Hayward, D. Paradot, S Watts Norfolk & Norwich University Hospital

46 BACPR Annual Conference 2019 Posters

9. Maximising digital opportunities in Cardiac Rehabilitation in London K. Read, C. Thomson, J. Colley, T. Kitto, A. King British Heart Foundation, NHSE London Cardiac Clinical Network, Health Innovation Network and NHS clinicians

10. Efficacy and safety of alirocumab in statin-intolerant patients over 3 years: Open-label extension of the ODYSSEY ALTERNATIVE trial P. Moriarty, P. Thompson, C. Cannon, J. Guyton, J. Bergeron, F. Zieve, E. Bruckert, T. Jacobson, M. Baccara-Dinet, J. Zhao, S. Donahue, S Ali, R. Pordy, D. Gipe, University of Kansas Medical Center, Kansas City

11. Pharmacodynamics of alirocumab in patients with autosomal dominant hypercholesterolaemia associated with PCSK9 gain-of-function or ApoB loss-of-function mutations: An open-label extension study M. Kremp, P. Hopkins, E. Bruckert, S. Lee, S. Donahue CHU de Nantes – Hôpital Nord Laennec, Saint-Herblain, France

12. Making the Right Call: Telephone consultation improves convenience and cost-effectiveness in Cardiac Rehabilitation S. Lockett, M. Berrisford, N. Cartner University Hospital of North Midlands NHS Trust

13. Web based Cardiac Rehab – A personalised approach P. Boden Walsall Heart Care

14. Assessing the effectiveness of hospital, community and web-based Cardiac Rehabilitation (CR) programmes to inform patient stratification approaches to personalised care M. Orme, C. Bourne, N. Gardiner, S. Singh University Hospitals of Leicester NHS Trust

15. Identifying the predictors of uptake and completion to hospital, community and web–based Cardiac Rehabilitation programmes to inform patient stratification approaches to personalised care C. Bourne, M. Orme, N. Gardiner, S. Singh University Hospitals of Leicester NHS Trust

‘Cardiovascular Disease and Multimorbidity’ 47 Posters

16. Cardiac stunning during haemodialysis: the therapeutic effect of intradialytic cycling S. McGuire, E.J. Horton, D. Renshaw, K. Chan, A. Jimenez, N. Krishnan, G. McGregor Coventry University

17. Pilot study of an exercise based rehabilitation programme after stroke and transient ischaemic attack A. Ali, E. Hocknell, D. Birds Sheffield Teaching Hospitals NHS Foundation Trust

18. The impact of education on cardiac patients’ health related quality of life and engagement in cardiac rehabilitation Z. Aziz, R. Thomson University of Glasgow, Department of MVLS (Medicine, Veterinary and Life Sciences) School of Nursing and healthcare, Greater Glasgow & Clyde Health Board

19. Understanding if the needs of CR attendees support network is being met focusing on their quality of life in their caring capacity A. Watt, E. Smedley, C. Bourne, N. Gardiner, S. Singh Cardiac Rehabilitation, Leicester Hospitals NHS Trust, Glenfield Hospital

20. Measuring physical activity in people with heart failure – An accelerometer calibration study G. Dibben, R. Taylor, H. Dalal, B. Metcalf, M. Gandhi, L. Tang, P. Doherty, M. Hillsdon. University of Exeter

21. An audit of LVEF in post MI patients and how to achieve a timely review in CR for those with established heart failure C. McIlduff, R. Robins, E. Smith, K. Sanghera, SJ. Brace-McDonnell University Hospitals Birmingham NHS Trust

22. Should the NHS be investing so much time and money into balanced diet health education and promotion to reduce obesity for type 2 diabetes prevention for the UK adult population A. Steward University of Nottingham

48 BACPR Annual Conference 2019 Posters

23. Exercise for Intermittent Claudication C.Scordis, R. Leslie, V .Isgar, P. Poulton Cardiac Rehab, New Cross Hospital, Wednesfield, Wolverhampton

24. Investigation of cardiac benefits of Sodium Glucose Co-Transporter Inhibition in Type 2 Diabetes using the zebrafish model F. Benslimiaine, Z. Zakaria , H Yalcin Qatar University

25. England’s national cardiovascular disease risk assessment programme (NHS Health Check): a systematic review of evaluations E. Dubois, H. Quezada-Yamamoto, G. Greenfield, A. Yazdi, M. Al-Saffar, F. Mannan, Z. Chaudhry, F. Hamid, S. Rawaf, A. Majeed, A Imperial College London

26. Developing and delivering a Multimorbidity and combined prevention/rehabilitation service: The Action Heart Experience R Tipson, EJ. Flint, A. Welsh Action Heart and Dudley Group of Hospitals NHS Foundation Trust

‘Cardiovascular Disease and Multimorbidity’ 49 notes

50 BACPR Annual Conference 2019 Future Diary Dates BACPR Exercise Professionals Group Spring Study Day Friday 15th May 2020 Aston University Birmingham Optimising Exercise Prescription in Cardiac Rehabilitation

Keynote speaker: • Professor Dominique Hansen, Professor of Rehabilitation and Exercise Physiology in Internal Disease, Faculty of Rehabilitation Sciences, University of Hasselt. • Dr Gordon McGregor, Clinical Exercise Physiologist, University Hospitals Coventry and Warwickshire NHS Trust, University of Warwick, and Coventry University Topics confirmed: • Exercise prescription in patients with cardiometabolic disease • Controversies in current cardiovascular rehabilitation • Results from the HIITorMISS UK Trial

Please contact Vivienne Stockley for further information and an application form [email protected] / 01252 854510

BCS Annual Conference 1 – 3 June 2020 Manchester Central, Manchester

Visit www.bcs.com/conference for online registration and programme

‘Cardiovascular Disease and Multimorbidity’ 51 BRITISH ASSOCIATION FOR CARDIOVASCULAR PREVENTION AND REHABILITATION

‘Cardiovascular Disease and Multimorbidity’ The British Association for Cardiovascular Prevention and Rehabilitation British Cardiovascular Society, 9 Fitzroy Square, London, W1T 5HW [email protected] +44 (0)20 7380 1919 www.bacpr.com

Registered Charity Number 1135639 Company limited by guarantee. Registered in England 5086964 52 BACPR Annual Conference 2019