Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:298

Article

Pio, Carolina Santiago de Araujo¹  Beckie, Theresa M.²  Varnfield, Marlien^3,4  Sarrafzadegan, Nizal^5,6  Babu, Abraham S.⁷  Baidya, Sumana⁸  Buckley, John⁹  Chen, Ssu-Yuan^10,11,12,13  Gagliardi, Anna¹⁴  Heine, Martin¹⁵  Khiong, Jong Seng¹⁶  Mola, Ana¹⁷  Radi, Basuni¹⁸  Supervia, Marta^19,20  Trani, Maria R.^21,22  Abreu, Ana^23,24  Sawdon, John A.²⁵  Moffatt, Paul D.²⁶  Grace, Sherry L.^1,27 

[1] York Univ, Sch Kinesiol & Hlth Sci, Toronto, ON, Canada

[2] Univ S Florida, Coll Nursing, Tampa, FL 33620 USA

[3] CSIRO, Australian EHlth Res Ctr, Canberra, ACT, Australia

[4] Australian Cardiovasc Hlth & Rehabil Assoc ACRA, St Leonards, NSW, Australia

[5] Univ British Columbia, Sch Populat & Publ Hlth, Fac Med, Vancouver, BC, Canada

[6] Isfahan Univ Med Sci, Cardiovasc Res Inst, Isfahan Cardiovasc Res Ctr, Esfahan, Iran

[7] Manipal Acad Higher Educ, Dept Physiotherapy, Manipal Coll Hlth Profess, Manipal, Karnataka, India

[8] Kathmandu Univ, Dhulikhel Hosp, Dhulikhel, Nepal

[9] Univ Ctr Shrewsbury, Ctr Act Living, Shrewsbury, Salop, England

[10] Fu Jen Catholic Univ, Fu Jen Catholic Univ Hosp, Dept Phys Med & Rehabil, New Taipei, Taiwan

[11] Fu Jen Catholic Univ, Coll Med, Sch Med, New Taipei, Taiwan

[12] Natl Taiwan Univ Hosp, Dept Phys Med & Rehabil, Taipei, Taiwan

[13] Natl Taiwan Univ, Coll Med, Taipei, Taiwan

[14] Univ Hlth Network, Toronto Gen Hosp, Res Inst, Toronto, ON, Canada

[15] Stellenbosch Univ, Fac Med & Hlth Sci, Inst Sport & Exercise Med, Cape Town, South Africa

[16] Raja Isteri Pengiran Anak Saleha Hosp, Bandar Seri Begawan, Brunei

[17] NYU, Sch Med, Rehabil Med, New York, NY USA

[18] Natl Cardiovasc Ctr Harapan Kita, Jakarta, Indonesia

[19] Gregorio Maranon Gen Univ Hosp, Dept Phys Med & Rehabil, Gregorio Maranon Hlth Res Inst, Dr Esquerdo 46, Madrid 28007, Spain

[20] Mayo Clin, Dept Cardiovasc Med, Div Prevent Cardiol, Rochester, MN USA

[21] Philippine Heart Assoc, Council Cardiac Rehabil & Sports Cardiol, Pasig, Philippines

[22] Chong Hua Hosp, Inst Heart, Cardiol Sect, Cebu, Philippines

[23] Hosp Santa Maria, CHLN, Dept Cardiol, Lisbon, Portugal

[24] Univ Lisbon, Sch Med, Lisbon, Portugal

[25] Cardiac Hlth Fdn Canada, Publ Educ & Special Projects, Toronto, ON, Canada

[26] Univ Hlth Network, Patient Partner Program, Toronto, ON, Canada

[27] Univ Toronto, Univ Hlth Network, KITE Toronto Rehabil Inst, Toronto, ON, Canada

关键词: Coronary artery disease;    Secondary prevention;    Health services accessibility;    Disease management;    Cardiac rehabilitation;   

DOI  :  10.1016/j.ijcard.2019.06.064

来源: Elsevier

【 摘 要 】

Background: 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 enrolment and adherence into implementable recommendations. Methods: The writing panel was constituted by representatives of societies internationally concerned with preventive cardiology, and included disciplines thatwould be implementing the recommendations. Patient partners served, as well as policy-makers. The statementwas developed in accordance with AGREE II, among other guideline checklists. Recommendations were based on our update of the Cochrane reviewon interventions to promote patient 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 GRADE). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrolment, healthcare 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 for the 3 recommendationswere 5.95 +/- 0.69 (mean +/- standard deviation), 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 CR programs are adequately resourced to serve enrolling patients and support them to complete programs. (C) 2019 Published by Elsevier B.V.

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