TY - JOUR
T1 - Promoting Patient Utilization of Outpatient Cardiac Rehabilitation
T2 - A JOINT INTERNATIONAL COUNCIL and CANADIAN ASSOCIATION of CARDIOVASCULAR PREVENTION and REHABILITATION POSITION STATEMENT
AU - Santiago De Araújo Pio, Carolina
AU - Beckie, Theresa M.
AU - Varnfield, Marlien
AU - Sarrafzadegan, Nizal
AU - Babu, Abraham S.
AU - Baidya, Sumana
AU - Buckley, John
AU - Chen, Ssu Yuan
AU - Gagliardi, Anna
AU - Heine, Martin
AU - Khiong, Jong Seng
AU - Mola, Ana
AU - Radi, Basuni
AU - Supervia, Marta
AU - Trani, Maria R.
AU - Abreu, Ana
AU - Sawdon, John A.
AU - Moffatt, Paul D.
AU - Grace, Sherry L.
N1 - Publisher Copyright:
© 2020 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Purpose: 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 enrollment 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 patients' 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 Grading of Recommendations Assessment, Development, and Evaluation [GRADE]). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrollment, health care 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 (mean ± SD) for the 3 recommendations were 5.95 ± 0.69, 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 that CR programs are adequately resourced to serve enrolling patients and support them to complete programs.
AB - Purpose: 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 enrollment 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 patients' 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 Grading of Recommendations Assessment, Development, and Evaluation [GRADE]). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrollment, health care 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 (mean ± SD) for the 3 recommendations were 5.95 ± 0.69, 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 that CR programs are adequately resourced to serve enrolling patients and support them to complete programs.
KW - cardiac rehabilitation
KW - coronary artery disease
KW - disease management
KW - health services accessibility
KW - secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=85083285811&partnerID=8YFLogxK
U2 - 10.1097/HCR.0000000000000474
DO - 10.1097/HCR.0000000000000474
M3 - Review article
C2 - 31764535
AN - SCOPUS:85083285811
SN - 1932-7501
VL - 40
SP - 79
EP - 86
JO - Journal of cardiopulmonary rehabilitation and prevention
JF - Journal of cardiopulmonary rehabilitation and prevention
IS - 2
ER -