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AuthorPesah E.
AuthorTurk-Adawi K.
AuthorSupervia M.
AuthorLopez-Jimenez F.
AuthorBritto R.
AuthorDing R.
AuthorBabu A.
AuthorSadeghi M.
AuthorSarrafzadegan N.
AuthorCuenza L.
AuthorAnchique Santos C.
AuthorHeine M.
AuthorDerman W.
AuthorOh P.
AuthorGrace S.L.
Available date2020-04-01T06:59:42Z
Publication Date2019
Publication NameHeart
ResourceScopus
ISSN13556037
URIhttp://dx.doi.org/10.1136/heartjnl-2018-314486
URIhttp://hdl.handle.net/10576/13682
AbstractObjective Cardiac rehabilitation (CR) availability, programme characteristics and barriers are not well-known in low/middle-income countries (LMICs). In this study, they were compared with high-income countries (HICs) and by CR funding source. Methods A cross-sectional online survey was administered to CR programmes globally. Need for CR was computed using incident ischaemic heart disease (IHD) estimates from the Global Burden of Disease study. General linear mixed models were performed. Results CR was identified in 55/138 (39.9%) LMICs; 47/55 (85.5% country response rate) countries participated and 335 (53.5% programme response) surveys were initiated. There was one CR spot for every 66 IHD patients in LMICs (vs 3.4 in HICs). CR was most often paid by patients in LMICs (n=212, 65.0%) versus government in HICs (n=444, 60.2%; p<0.001). Over 85% of programmes accepted guideline-indicated patients. Cardiologists (n=266, 89.3%), nurses (n=234, 79.6%; vs 544, 91.7% in HICs, p=0.001) and physiotherapists (n=233, 78.7%) were the most common providers on CR teams (mean=5.8±2.8/programme). Programmes offered 7.3±1.8/10 core components (vs 7.9±1.7 in HICs, p<0.01) over 33.7±30.7 sessions (significantly greater in publicly funded programmes; p<0.001). Publicly funded programmes were more likely to have social workers and psychologists on staff, and to offer tobacco cessation and psychosocial counselling. Conclusion CR is only available in 40% of LMICs, but where offered is fairly consistent with guidelines. Governments should enact policies to reimburse CR so patients do not pay out-of-pocket.
SponsorFunding this project was supported by a research grant from York University's Faculty of health. Funding was used to translate the survey into spanish and chinese characters.
Languageen
PublisherBMJ Publishing Group
Subjectacute myocardial infarction
cardiac rehabilitation
global health
health care delivery
TitleCardiac rehabilitation delivery in low/middle-income countries
TypeArticle
Pagination1806-1812
Issue Number23
Volume Number105
dc.accessType Abstract Only


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