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


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 01 2020
Historique:
received: 25 03 2019
revised: 17 06 2019
accepted: 24 06 2019
pubmed: 14 8 2019
medline: 24 11 2020
entrez: 14 8 2019
Statut: ppublish

Résumé

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. The writing panel was constituted by representatives of societies internationally concerned with preventive cardiology, and included disciplines that would be implementing the recommendations. Patient partners served, as well as policy-makers. The statement was developed in accordance with AGREE II, among other guideline checklists. Recommendations were based on our update of the Cochrane review on 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. 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 recommendations were 5.95 ± 0.69 (mean ± standard deviation), 5.33 ± 1.12 and 5.64 ± 1.08, respectively. 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.

Sections du résumé

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 that would be implementing the recommendations. Patient partners served, as well as policy-makers. The statement was developed in accordance with AGREE II, among other guideline checklists. Recommendations were based on our update of the Cochrane review on 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 recommendations were 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.

Identifiants

pubmed: 31405584
pii: S0167-5273(19)31295-1
doi: 10.1016/j.ijcard.2019.06.064
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1-7

Informations de copyright

Copyright © 2019. Published by Elsevier B.V.

Auteurs

Carolina Santiago de Araújo Pio (C)

School of Kinesiology and Health Science, York University, Toronto, Canada.

Theresa M Beckie (TM)

College of Nursing, University of South Florida, Tampa, USA.

Marlien Varnfield (M)

Australian eHealth Research Centre, CSIRO, and Australian Cardiovascular Health and Rehabilitation Association (ACRA), Australia.

Nizal Sarrafzadegan (N)

Faculty of Medicine, School of Population and Public Health, The University of British Columbia, Vancouver, Canada; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Abraham S Babu (AS)

Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Sumana Baidya (S)

Kathmandu University, Dhulikhel Hospital, Dhulikhel, Nepal.

John Buckley (J)

Centre for Active Living, University Centre Shrewsbury, Shrewsbury, UK.

Ssu-Yuan Chen (SY)

Department of Physical Medicine & Rehabilitation, Fu Jen Catholic University Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan; Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

Anna Gagliardi (A)

Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.

Martin Heine (M)

Institute of Sport and Exercise Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Jong Seng Khiong (JS)

Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam.

Ana Mola (A)

Rehabilitation Medicine, New York University School of Medicine, New York City, NY, USA.

Basuni Radi (B)

National Cardiovascular Center Harapan Kita, Jakarta, Indonesia.

Marta Supervia (M)

Department of Physical Medicine and Rehabilitation, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Dr. Esquerdo, 46, 28007 Madrid, Spain; Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, MN, USA.

Maria R Trani (MR)

Council of Cardiac Rehabilitation and Sports Cardiology, Philippine Heart Association, Pasig City, Philippines and Section of Cardiology, Chong Hua Hospital Heart Institute, Cebu City, Philippines.

Ana Abreu (A)

Cardiology Department, Hospital Santa Maria, CHLN, Lisbon, Portugal; Medical School of University of Lisbon, Lisbon, Portugal.

John A Sawdon (JA)

Public Education and Special Projects, Cardiac Health Foundation of Canada, Toronto, Canada.

Paul D Moffatt (PD)

Patient Partner Program, University Health Network, Toronto, Canada.

Sherry L Grace (SL)

School of Kinesiology and Health Science, York University, Toronto, Canada; KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Canada. Electronic address: sgrace@yorku.ca.

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