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. 2018 Sep 7;7(9):260.
doi: 10.3390/jcm7090260.

Cardiac Rehabilitation Models around the Globe

Gabriela Lima de Melo Ghisi  1   2 , Ella Pesah  3 , Karam Turk-Adawi  4 , Marta Supervia  5 , Francisco Lopez Jimenez  6 , Sherry L Grace  7   8
Affiliations

Cardiac Rehabilitation Models around the Globe

Gabriela Lima de Melo Ghisi et al. J Clin Med. .

Abstract

Alternative models of cardiac rehabilitation (CR) delivery, such as home or community-based programs, have been developed to overcome underutilization. However, their availability and characteristics have never been assessed globally. In this cross-sectional study, a piloted survey was administered online to CR programs globally. CR was available in 111/203 (54.7%) countries globally; data were collected in 93 (83.8% country response rate). 1082 surveys (32.1% program response rate) were initiated. Globally, 85 (76.6%) countries with CR offered supervised programs, and 51 (45.9%; or 25.1% of all countries) offered some alternative model. Thirty-eight (34.2%) countries with CR offered home-based programs, with 106 (63.9%) programs offering some form of electronic CR (eCR). Twenty-five (22.5%) countries with CR offered community-based programs. Where available, programs served a mean of 21.4% ± 22.8% of their patients in home-based programs. The median dose for home-based CR was 3 sessions (Q25-Q75 = 1.0⁻4.0) and for community-based programs was 20 (Q25⁻Q75 = 9.6⁻36.0). Seventy-eight (47.0%) respondents did not perceive they had sufficient capacity to meet demand in their home-based program, for reasons including funding and insufficient staff. Where alternative CR models are offered, capacity is insufficient half the time. Home-based CR dose is insufficient to achieve health benefits. Allocation to program model should be evidence-based.

Keywords: cardiac rehabilitation; international health; patient education as topic; surveys and questionnaires.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Countries That Offer Any Alternative Models of Cardiac Rehabilitation around the Globe. CR = cardiac rehabilitation.
Figure 2
Figure 2
Forms of Communication in Home-Based Programs and Their Mean Frequency of Use Globally, n = 166.
Figure 3
Figure 3
Needed elements to increase capacity of alternative model delivery. (a) home-based; (b) community-based.
See this image and copyright information in PMC

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