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Purpose This PhD study explores the perspectives and experiences of people who do not use existing cardiac resources following a myocardial infarction (MI)/‘heart attack’, and of their family members/friends. How might the system of post-MI support be improved to help more people care for their heart instead of ‘voting with their feet’? Background A large proportion of post-MI people, and particularly certain demographic groups, do not attend Cardiac Rehabilitation (CR)—the main support programme following an MI/‘heart attack’, or Cardiac Support Groups (CSGs)—the main community-based resource. Research indicates that post-MI people experience difficulties recovering after an MI and undertaking secondary prevention measures, and family members/carers experience difficulty supporting this process. Little is known or understood about the substantial ‘non-participant’ group. Methods Qualitatative study in Lothian region, Scotland. In-depth interviews with 27 post-MI ‘non-participants’ identified by screening questionnaire from the wider post-MI population, and 17 family members/friends. Findings and Implications Insight is given into the perspectives of people who did not use CR and/or a CSG about the reasons for non-use and their experiences of post-MI rehabilitation/recovery and managing CHD without these resources. Implications of the findings in terms of these specific resources and the current model of post-MI support are discussed. Suggestions are made for ways that a more integrated post-MI support system might cater better for the needs of people who otherwise may end up outside the system without the support they require.

Developing a more integrated support system for people post-MI: lessons from the research evidence