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Cardiac Rehabilitation Delivery Model for Low-Resource Settings: An International Council of Cardiovascular Prevention and Rehabilitation Consensus Statement Publisher Pubmed



Grace SL1, 2, 12 ; Turkadawi KI3 ; Contractor A4, 12 ; Atrey A5 ; Campbell NRC6 ; Derman W7 ; Ghisi GLM1 ; Sarkar BK8 ; Yeo TJ9 ; Lopezjimenez F10 ; Buckley J11, 12 ; Hu D13 ; Sarrafzadegan N14
Authors
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Authors Affiliations
  1. 1. School of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele Street, Toronto, M3J 1P3, Ontario, Canada
  2. 2. Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
  3. 3. School of Health Policy and Management, York University, 4700 Keele Street, Toronto, M3J 1P3, Ontario, Canada
  4. 4. Rehabilitation and Sports Medicine, Sir H.N. Reliance Foundation Hospital, Raja Ram Mohan Roy Road, Mumbai, 400004, India
  5. 5. Imperial College, 2 Bar Close, Stapleford, CB22 5BY, Cambridgeshire, United Kingdom
  6. 6. Libin Cardiovascular Institute of Alberta, University of Calgary, 3280 Hospital Drive NW, Calgary, T2N 4Z6, Alberta, Canada
  7. 7. Institute of Sport & Exercise Medicine (SEM) within the Faculty of Medicine & Health Sciences at the University of Stellenbosch, Cape Town, South Africa
  8. 8. Research Division, Public Health Foundation of India, ISID Campus, Vasant Kunj, New Delhi, India
  9. 9. Department of Cardiology, National University Heart Centre, 5 Lower Kent Ridge Rd, 119074, Singapore
  10. 10. Cardiovascular Health Clinic and Cardiometabolic Program at Mayo Clinic, Rochester, MN, United States
  11. 11. Institute of Medicine, University Centre Shrewsbury, United Kingdom
  12. 12. International Council of Cardiovascular Prevention and Rehabilitation, United Kingdom
  13. 13. People Hospital of Peking University, 11# Xizhimen S. Ave, Beijing, 100044, China
  14. 14. Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Khorram Ave, PO Box 81465-1148, Isfahan, Iran

Source: Progress in Cardiovascular Diseases Published:2016


Abstract

Cardiovascular disease (CVD) is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be efficacious and cost-effective for secondary prevention in high-income countries. Given its affordability, CR should be more broadly implemented in middle-income countries as well. Hence, the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) convened a writing panel to recommend strategies to deliver all core CR components in low-resource settings, namely: (1) initial assessment, (2) lifestyle risk factor management (i.e., diet, tobacco, mental health), (3) medical risk factor management (lipids, blood pressure), (4) education for self-management; (5) return to work; and (6) outcome evaluation. Approaches to delivering these components in alternative, arguably lower-cost settings, such as the home, community and primary care, are provided. Recommendations on delivering each of these components where the most-responsible CR provider is a non-physician, such as an allied healthcare professional or community health care worker, are also provided. © 2016 Elsevier Inc.
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