Secondary prevention and self-management of coronary heart disease (CHD) are of major importance to people who survive myocardial infarction (MI). This can be facilitated by cardiac rehabilitation (CR; the formal health service programme) and informal CHD self-help groups. Non-participation is an important issue, yet it is poorly understood. Rehabilitation difficulties and prevention challenges have been identified among people following MI, but the particular experience and perspective of CR and CHD group non-participants are largely unknown.

The study aimed to understand non-participation in CR and CHD self-help groups from the perspectives of the non-participants and to provide insight into their experience and that of their ‘significant others’ in rehabilitating in the absence of these resources.

In-depth interviews were conducted with 27 people who had not participated in either hospital-based CR or a CHD group, 6–14 months post-MI, and 17 ‘significant others’ in Lothian, Scotland.

Factors influencing non-participation fell into three broad themes ‘No need/no point’, ‘Not worth it’, and ‘Not possible’. In the latter two categories, non-participation in these resources was often considered a ‘missed opportunity’ and needs had remained unmet. Shifts between categories could occur over time. Non-participation was linked to rehabilitation difficulties for some people and family members. Recommendations to enhance post-MI support are made.

An increasing number of blood tests are being performed in primary care. Informing patients of results takes up a considerable proportion of practice-staff time. The use of new technologies may be more time-efficient for staff but little is known about the acceptability to patients.

To determine patient attitudes towards the use of three technologies – short message service (SMS), webpage and e-mail – for the delivery of laboratory results.

Structured interview.

Two hundred patients were interviewed in two general practices in Lothian, Scotland. Satisfaction with current methods and preferred methods of obtaining test-results were assessed. Patients were asked about their current access to different technologies and their favourability to using such technologies for receiving results and their views on appropriate content and information security. Results were analyzed by age, sex and educational attainment using χ2 test.

A total of 79.5% of patients had mobile phones, 53% used SMS, 46.5% had internet, and 37.5% used e-mail. E-mail, SMS and webpage was the favoured delivery system for 53.3%, 37.1% and 33.3%, respectively.

Patients were favourable towards e-mail but not SMS or a webpage. The main concern over the three technologies was information security. New technology may be useful for delivering results but patients will have to be persuaded that any such system is reliable and secure.

To establish the acceptability of telemetric monitoring of blood pressure to patients and clinicians.

Telemetric monitoring of blood pressure (BP) may allow clinicians and patients, in partnership, to more quickly control high BP through medication and lifestyle alterations. However, it is not clear if patients and clinicians would find such a system acceptable.

Questionnaire study followed by focus groups of patients with high BP, and clinicians involved in managing BP.

We received responses from 25 (50%) practice nurses, 76 (50%) general practitioners and 126 (62%) patients. We ran three focus groups of patients and clinicians. Participants were supportive of the technology, willing to try it, thought it would encourage adherence to medication and lifestyle and felt it would diagnose problems sooner than current methods. However, both groups thought the technology would be more useful for new patients or those whose BP was uncontrolled. They were concerned that individual high readings might provoke anxiety and thought patients would need reassurances about this. Clinicians were concerned about workload and the responsibility to act immediately when faced with a continuous stream of readings, regardless of how inconvenient this may be.

Participants, in general, welcomed this technology and thought it would aid adherence to medication and lifestyle advice, but felt it was most suitable to those with newly diagnosed or uncontrolled hypertension. Patients will need to be educated and reassured about the nature of occasional high readings and the need to consider average BP.