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‘It Shouldn’t Be This Hard’: Exploring the Challenges of Rural Health Research
Open AccessReview

Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

1
Western Australian Centre for Rural Health, The University of Western Australia, P.O. Box 109, Geraldton 6531, Australia
2
School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Highway, Perth 6009, Australia
3
Menzies Institute for Medical Research, University of Tasmania, 15-17 Liverpool Street, Hobart, Tasmania 7000, Australia
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(24), 5126; https://doi.org/10.3390/ijerph16245126
Received: 9 November 2019 / Revised: 9 December 2019 / Accepted: 12 December 2019 / Published: 15 December 2019
(This article belongs to the Special Issue Rural and Remote Health)
This narrative review explores relevant literature that is related to the challenges in implementing evidence-based management for clinicians in rural and remote areas, while primarily focussing on management of acute coronary syndrome (ACS) and follow up care. A targeted literature search around rural/urban differences in the management of ACS, cardiovascular disease, and cardiac rehabilitation identified multiple issues that are related to access, including the ability to pay, transport and geographic distances, delays in patients seeking care, access to diagnostic testing, and timely treatment in an appropriate facility. Workforce shortages or lack of ready access to relevant expertise, cultural differences, and complexity that arises from comorbidities and from geographical isolation amplified diagnostic challenges. Given the urgency in management of ACS, rural clinicians must act quickly to achieve optimal patient outcomes. New technologies and quality improvement approaches enable better access to rapid diagnosis, as well as specialist input and care. Achieving an uptake of cardiac rehabilitation in rural and remote settings poses challenges that may reduce with the use of alternative models to centre-based rehabilitation and use of modern technologies. Expediting improvement in cardiovascular outcomes and reducing rural disparities requires system changes and that clinicians embrace attention to prevention, emergency management, and follow up care in rural contexts. View Full-Text
Keywords: rural; remote; acute coronary syndrome; revascularization; cardiac rehabilitation; cardiovascular; prevention; workforce; primary care; access; outcomes; review rural; remote; acute coronary syndrome; revascularization; cardiac rehabilitation; cardiovascular; prevention; workforce; primary care; access; outcomes; review
MDPI and ACS Style

Thompson, S.C.; Nedkoff, L.; Katzenellenbogen, J.; Hussain, M.A.; Sanfilippo, F. Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review. Int. J. Environ. Res. Public Health 2019, 16, 5126.

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