University of Oulu

Marta Supervia, Karam Turk-Adawi, Francisco Lopez-Jimenez, Ella Pesah, Rongjing Ding, Raquel R. Britto, Birna Bjarnason-Wehrens, Wayne Derman, Ana Abreu, Abraham S. Babu, Claudia Anchique Santos, Seng K. Jong, Lucky Cuenza, Tee Joo Yeo, Dawn Scantlebury, Karl Andersen, Graciela Gonzalez, Vojislav Giga, Dusko Vulic, Eleonora Vataman, Jacqueline Cliff, Evangelia Kouidi, Ilker Yagci, Chul Kim, Briseida Benaim, Eduardo Rivas Estany, Rosalia Fernandez, Basuni Radi, Dan Gaita, Attila Simon, Ssu-Yuan Chen, Brendon Roxburgh, Juan Castillo Martin, Lela Maskhulia, Gerard Burdiat, Richard Salmon, Hermes Lomelí, Masoumeh Sadeghi, Eliska Sovova, Arto Hautala, Egle Tamuleviciute-Prasciene, Marco Ambrosetti, Lis Neubeck, Elad Asher, Hareld Kemps, Zbigniew Eysymontt, Stefan Farsky, Jo Hayward, Eva Prescott, Susan Dawkes, Claudio Santibanez, Cecilia Zeballos, Bruno Pavy, Anna Kiessling, Nizal Sarrafzadegan, Carolyn Baer, Randal Thomas, Dayi Hu, Sherry L. Grace, Nature of Cardiac Rehabilitation Around the Globe, EClinicalMedicine, Volume 13, 2019, Pages 46-56, ISSN 2589-5370, https://doi.org/10.1016/j.eclinm.2019.06.006

Nature of cardiac rehabilitation around the globe

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Author: Supervia, Marta1,2; Turk-Adawi, Karam3; Lopez-Jimenez, Francisco2;
Organizations: 1Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Dr. Esquerdo, 46, 28007 Madrid, Spain
2Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
3QU Health, Qatar University, Al Jamiaa St, Doha, Qatar
4York University, 4700 Keele Street, Toronto, Ontario M3J1P3, Canada
5Peiking University People' Hospital, 11 Xizhimen S St, Xicheng Qu, Beijing Shi, China
6Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 - Pampulha, Belo Horizonte, MG 31270-901, Brazil
7Institute for Cardiology and Sports Medicine, Dep. Preventive and Rehabilitative Sport Medicine and Exercise Physiology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
8Stellenbosch University & International Olympic Committee Research Center South Africa, Francie Van Zijl Drive, Stellenbosch 7599, South Africa
9Hospital Santa Marta, R. de Santa Marta 50, Lisbon 1169-024, Portugal
10Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal - 576104, Karnataka
11Mediagnóstica Duitama, Cra16 #14-68 oficina 201, Duitama, Boyacá, Colombia
12Hospital Raja Isteri Pengiran Anak Saleha, Bandar Seri Begawan BA1710, Brunei
13Philippine Heart Center, East Avenue, Quezon City 1100, Philippines
14National University Heart Centre Singapore, National University Health System Tower Block, 1E Kent Ridge Road, Level 9, Cardiac Department, Singapore 119228, Singapore
15University of the West Indies at Cave Hill, St. Michael, Barbados
16University of Iceland, Saemundargata 2, IS-101 Reykjavik, Iceland
17Central Hospital of Social Security Institute, Asuncion, Paraguay
18Institute of Cardiovascular Diseases, Clinical Center of Serbia, Dr. Koste Todorovića 8, 11000 Beograd, Serbia
19University of Banja Luka, Faculty of Medicine, Save Mrkalja 14, 78000 Banja Luka, Bosnia and Herzegovina
20Institute of Cardiology, Str. Testemitanu, 20, Chisinau, Republic of Moldova
21Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, Wales, United Kingdom
22Laboratory of Sports Medicine, Aristotle University of Thessaloniki, Thessaloniki 57001, Greece
23Marmara University, School of Medicine, Department of Physical Medicine and Rehabilitation, Fevzi Çakmak Mah Muhsin Yazıcıoğlu Cad. No:10 Üst Kaynarca Pendik / İstanbul, Turkey
24Sanggye Paik Hospital, Inje University, Dongil-ro 1342, Nowon-gu, Seoul, Republic of Korea
25Asociacion Cardiovascular Centroccidental (ASCARDIO), 17 Callejón 12, Barquisimeto 3001, Lara, Venezuela
26ICCCV Instituto de Cardiología y Cirugía Cardiovascular, No. 702 entre A y Paseo, Vedado, Calle 17, La Habana, Cuba
27Instituto Nacional Cardiovascular (INCOR), Jirón Coronel Zegarra, Jesus Maria, Lima 11, Peru
28National Cardiovascular Center Harapan Kita, Kav 87, Jl. Letjen. S. Parman, Jakarta, Indonesia
29University of Medicine & Pharmacy “Victor Babes”, Cardiovascular Prevention & Rehabilitation Clinic, Bvd CD Loga 49, 300020 Timisoara, Romania
30State Hospital for Cardiology, Gyógy tér 2, Balatonfüred 8230, Hungary
31Fu Jen Catholic University Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, No. 69, Guizi Road, Taishan District, New Taipei City 24352, Taiwan
32The University of Auckland, 71 Merton Road, Private Bag 92019, Auckland 1142, New Zealand
3312 Octubre Universitary Hospital, Av. Cordoba, s/n, 28041 Madrid, Spain
34Tbilisi State Medical University, 33 Vazha Pshavela Ave, Tbilisi, Georgia
35Spanish Association Hospital, Bulevar Gral. Artigas 1471, Montevideo 1471, Uruguay
36PHYSIS Prevencion Cardiovascular, Cdla Bolivariana Av. del Libertador - Mz I Villa 5, Guayaquil, Ecuador
37Instituto Nacional de Cardiología, Belisario Domínguez Sección 16, Tlalpan, 14080 CDMX, Mexico
38Cardiac Rehabilitation Research Centre, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Hezar-Jerib Ave., Isfahan 81746 73461, IR, Iran
39University of Palacky, University Hospital Olomouc, I.P. Pavlova 185/6, Nová Ulice, 779 00 Olomouc, Czech Republic
40Cardiovascular Research Group, Division of Cardiology, Oulu University Hospital, University of Oulu, Finland
41Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, Kaunas 44307, Lithuania
42Istituti Clinici Scientifici Maugeri, Care and Research Institute, Department of Cardiac Rehabilitation, Pavia, Italy
43Edinburgh Napier University, 9 Sighthill Ct, Edinburgh EH11 4BN, Scotland, United Kingdom
44Shaare Zedek Medical Center, the Hebrew University, Jerusalem, Israel
45Maxima Medical Centre, De Run 4600, 5504 DB Veldhoven, Netherlands
46Ślaskie Centrum Rehabilitacji w Ustroniu, Zdrojowa 6, 43-450 Ustroń, Poland
47Heart House Martin, Bagarova 30, Martin, Podháj, Slovakia
48Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, United Kingdom
49Bispebjerg Frederiksberg Hospital, Bispebjerg Bakke 23, 2400 København, NV, Denmark
50Sociedad Chilena de Cardiología, Alfredo Barros Errázuriz 1954, Providencia, Región Metropolitana, Chile
51Cardiovascular Institute of Buenos Aires, Av. del Libertador 6302, 1428 Buenos Aires, Argentina
52Loire-Vendée-Océan Hospital, Boulevard des Régents, 44270 Machecoul, France
53Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, 182 88 Stockholm, Sweden
54University of British Columbia, 2206 East Mall, Vancouver, British Colombia V6T 1Z3, Canada
55Moncton Hospital, 135 Macbeath Ave, Moncton, New Brunswick E1C 6Z8, Canada
56Beijing United Family Hospital, 2 Jiangtai Rd, Chaoyang Qu, Beijing Shi 100096, China
57University Health Network, 399 Bathurst St, Toronto, ON M5T 2S8, Canada
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe202003198537
Language: English
Published: Elsevier, 2019
Publish Date: 2020-03-19
Description:

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 < 0.001), dietitians (n = 739, 80.2%), and physiotherapists (n = 733, 79.3%). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8%; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2%), patient education (n = 895, 96.9%), and exercise (n = 898, 94.3%; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75% for tobacco cessation and return-to-work counseling (lower in Americas, p = < 0.05).

Interpretation: This first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes.

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Series: EClinicalMedicine
ISSN: 2589-5370
ISSN-E: 2589-5370
ISSN-L: 2589-5370
Volume: 13
Pages: 46 - 56
DOI: 10.1016/j.eclinm.2019.06.006
OADOI: https://oadoi.org/10.1016/j.eclinm.2019.06.006
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Copyright information: © 2019 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
  https://creativecommons.org/licenses/by-nc-nd/4.0/