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Promoting Patient Utilization of Outpatient Cardiac Rehabilitation: A Joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation Position Statement Publisher Pubmed



Santiago De Araujo Pio C1 ; Beckie TM2 ; Varnfield M3, 4 ; Sarrafzadegan N5, 6 ; Babu AS7 ; Baidya S8 ; Buckley J9 ; Chen SY10, 11 ; Gagliardi A12 ; Heine M13 ; Khiong JS14 ; Mola A15 ; Radi B16 ; Supervia M17, 18 Show All Authors
Authors
  1. Santiago De Araujo Pio C1
  2. Beckie TM2
  3. Varnfield M3, 4
  4. Sarrafzadegan N5, 6
  5. Babu AS7
  6. Baidya S8
  7. Buckley J9
  8. Chen SY10, 11
  9. Gagliardi A12
  10. Heine M13
  11. Khiong JS14
  12. Mola A15
  13. Radi B16
  14. Supervia M17, 18
  15. Trani MR19
  16. Abreu A20, 21
  17. Sawdon JA22
  18. Moffatt PD23
  19. Grace SL24

Source: Journal of Cardiopulmonary Rehabilitation and Prevention Published:2020


Abstract

Purpose: Cardiac rehabilitation (CR) is a recommendation in international clinical practice guidelines given its benefits; however, use is suboptimal. The purpose of this position statement was to translate evidence on interventions that increase CR enrollment and adherence into implementable recommendations. Methods: The writing panel was constituted by representatives of societies internationally concerned with preventive cardiology and included disciplines that would be implementing the recommendations. Patient partners served, as well as policy makers. The statement was developed in accordance with AGREE II, among other guideline checklists. Recommendations were based on our update of the Cochrane review on interventions to promote patients' utilization of CR. These were circulated to panel members, who were asked to rate each on a 7-point Likert scale in terms of scientific acceptability, actionability, and feasibility of assessment. A Web call was convened to achieve consensus and confirm strength of the recommendations (based on Grading of Recommendations Assessment, Development, and Evaluation [GRADE]). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrollment, health care providers, particularly nurses (strong), should promote CR to patients face-to-face (strong), and that to increase adherence, part of CR could be delivered remotely (weak). Ratings (mean ± SD) for the 3 recommendations were 5.95 ± 0.69, 5.33 ± 1.12, and 5.64 ± 1.08, respectively. Conclusions: Interventions can significantly increase utilization of CR and hence should be widely applied. We call upon cardiac care institutions to implement these strategies to augment CR utilization and to ensure that CR programs are adequately resourced to serve enrolling patients and support them to complete programs. © 2020 Wolters Kluwer Health, Inc. All rights reserved.
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