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Nature of Cardiac Rehabilitation Around the Globe Publisher



Supervia M1, 2 ; Turkadawi K3 ; Lopezjimenez F2 ; Pesah E4 ; Ding R5 ; Britto RR6 ; Bjarnasonwehrens B7 ; Derman W8 ; Abreu A9 ; Babu AS10 ; Santos CA11 ; Jong SK12 ; Cuenza L13 ; Yeo TJ14 Show All Authors
Authors
  1. Supervia M1, 2
  2. Turkadawi K3
  3. Lopezjimenez F2
  4. Pesah E4
  5. Ding R5
  6. Britto RR6
  7. Bjarnasonwehrens B7
  8. Derman W8
  9. Abreu A9
  10. Babu AS10
  11. Santos CA11
  12. Jong SK12
  13. Cuenza L13
  14. Yeo TJ14
  15. Scantlebury D15
  16. Andersen K16
  17. Gonzalez G17
  18. Giga V18
  19. Vulic D19
  20. Vataman E20
  21. Cliff J21
  22. Kouidi E22
  23. Yagci I23
  24. Kim C24
  25. Benaim B25
  26. Estany ER26
  27. Fernandez R27
  28. Radi B28
  29. Gaita D29
  30. Simon A30
  31. Chen SY31
  32. Roxburgh B32
  33. Martin JC33
  34. Maskhulia L34
  35. Burdiat G35
  36. Salmon R36
  37. Lomeli H37
  38. Sadeghi M38
  39. Sovova E39
  40. Hautala A40
  41. Tamuleviciuteprasciene E41
  42. Ambrosetti M42
  43. Neubeck L43
  44. Asher E44
  45. Kemps H45
  46. Eysymontt Z46
  47. Farsky S47
  48. Hayward J48
  49. Prescott E49
  50. Dawkes S43
  51. Santibanez C50
  52. Zeballos C51
  53. Pavy B52
  54. Kiessling A53
  55. Sarrafzadegan N54
  56. Baer C55
  57. Thomas R2
  58. Hu D56
  59. Grace SL4, 57

Source: EClinicalMedicine Published:2019


Abstract

Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models. Findings: 111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p < 0.001), dietitians (n = 739, 80.2%), and physiotherapists (n = 733, 79.3%). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8%; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2%), patient education (n = 895, 96.9%), and exercise (n = 898, 94.3%; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75% for tobacco cessation and return-to-work counseling (lower in Americas, p = < 0.05). Interpretation: This first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes. © 2019
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