Ms Irene Gibson:

I will start with by giving a little background. The Senator will have heard about the burden of cardiovascular disease. Between 30% and 50% of cardiovascular disease occurs in patients with existing disease. That is why secondary prevention is so important. When the pandemic hit, 70% of cardiac rehabilitation services in Ireland were significantly affected. Staff were redeployed and centres were closed. One of the projects led by Croí under the Sláintecare integration funding was the development of a virtual cardiac prevention and rehabilitation programme. In essence, it provided an online web-based programme of care to individuals living with cardiovascular disease. Many of these patients were waiting in excess of three to 12 months for preventative care. Some of these problems existed prior to the pandemic. In Ireland, capacity for cardiac rehabilitation is around 37%. We need to look at alternative ways of delivering care.

One of the positives of the pandemic is that we can deliver care digitally and it is acceptable to patients. Over a period of 12 weeks, we offered people an intensive lifestyle and medical risk factor management programme led by a nurse prescriber, supported by a multidisciplinary team of dieticians and physiotherapists under the medical governance of a cardiologist and in collaboration with general practice and community pharmacists. Under the programme, patients joined us once per week for an online Zoom session, such as we are engaged in today, where they completed a supervised exercise session and participated in an interactive health promotion session. A key component of that session focused on self-management. We provided patients with blood pressure monitors to track their blood pressure. We also gave them Fitbits to track their physical activity levels. In looking at the lifestyle factors that contribute to cardiovascular disease, we need to also look at engaging with people in a way that goes way beyond education and information giving. We need to work with people on identifying their goals and priorities for change. We have been astounded by the outcomes of this programme. Over a short timeframe, we have seen anxiety and depression levels halve, an 80% improvement in blood pressure control and improvements of 40% to 60% in cholesterol levels. In terms of our care for cardiovascular patients, we are not meeting the recommended targets and guidelines. That is a real priority.