Nature of Cardiac Rehabilitation Around the Globe

Supervia, Marta; Turk-Adawi, Karam; Lopez-Jimenez, Francisco; Pesah, Ella; Ding, Rongjing; Britto, Raquel R.; Bjarnason-Wehrens, Birna; Derman, Wayne; Abreu, Ana; Babu, Abraham S.; Santos, Claudia Anchique; Jong, Seng K.; Cuenza, Lucky; Yeo, Tee Joo; Scantlebury, Dawn; Andersen, Karl; Gonzalez, Graciela; Giga, Vojislav; Vulic, Dusko; Vataman, Eleonora; Cliff, Jacqueline; Kouidi, Evangelia; Yagci, Ilker; Kim, Chul; Benaim, Briseida; Estany, Eduardo Rivas; Fernandez, Rosalia; Radi, Basuni; Gaita, Dan; Simon, Attila; Chen, Ssu-Yuan; Roxburgh, Brendon; Martin, Juan Castillo; Maskhulia, Lela; Burdiat, Gerard; Salmon, Richard; Lomel?, Hermes; Sadeghi, Masoumeh; Sovova, Eliska; Hautala, Arto; Tamuleviciute-Prasciene, Egle; Ambrosetti, Marco; Neubeck, Lis; Asher, Elad; Kemps, Hareld; Eysymontt, Zbigniew; Farsky, Stefan; Hayward, Jo; Prescott, Eva; Dawkes, Susan; Santibanez, Claudio; Zeballos, Cecilia; Pavy, Bruno; Kiessling, Anna; Sarrafzadegan, Nizal; Baer, Carolyn; Thomas, Randal; Hu, Dayi;...

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 

• Journal Article Type: Article
• Acceptance Date: Jun 12, 2019
• Online Publication Date: Jul 4, 2019
• Publication Date: 2019-08
• Deposit Date: Dec 16, 2020
• Publicly Available Date: Dec 16, 2020
• Journal: EClinicalMedicine
• Electronic ISSN: 2589-5370
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 13
• Pages: 46-56
• DOI: https://doi.org/10.1016/j.eclinm.2019.06.006
• Keywords: Cardiac rehabilitation, Nature, Preventive cardiology, Global health, Health services, Survey
• Public URL: http://researchrepository.napier.ac.uk/Output/2712020