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Open AccessArticle

Cardiac Rehabilitation Models around the Globe

1
Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON M5G2A2, Canada
2
School of Kinesiology and Health Science, York University, Toronto, ON M3J1P3, Canada
3
Public Health Department, College of Health Sciences, Qatar University, Al Jamiaa St, Doha, P.O. Box 2713, Qatar
4
Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, 28007 Madrid, Spain
5
Mayo Clinic, Rochester, MN 55905, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(9), 260; https://doi.org/10.3390/jcm7090260
Received: 23 August 2018 / Revised: 31 August 2018 / Accepted: 3 September 2018 / Published: 7 September 2018
(This article belongs to the Special Issue Cardiac Rehabilitation)
Alternative models of cardiac rehabilitation (CR) delivery, such as home or community-based programs, have been developed to overcome underutilization. However, their availability and characteristics have never been assessed globally. In this cross-sectional study, a piloted survey was administered online to CR programs globally. CR was available in 111/203 (54.7%) countries globally; data were collected in 93 (83.8% country response rate). 1082 surveys (32.1% program response rate) were initiated. Globally, 85 (76.6%) countries with CR offered supervised programs, and 51 (45.9%; or 25.1% of all countries) offered some alternative model. Thirty-eight (34.2%) countries with CR offered home-based programs, with 106 (63.9%) programs offering some form of electronic CR (eCR). Twenty-five (22.5%) countries with CR offered community-based programs. Where available, programs served a mean of 21.4% ± 22.8% of their patients in home-based programs. The median dose for home-based CR was 3 sessions (Q25−Q75 = 1.0–4.0) and for community-based programs was 20 (Q25–Q75 = 9.6–36.0). Seventy-eight (47.0%) respondents did not perceive they had sufficient capacity to meet demand in their home-based program, for reasons including funding and insufficient staff. Where alternative CR models are offered, capacity is insufficient half the time. Home-based CR dose is insufficient to achieve health benefits. Allocation to program model should be evidence-based. View Full-Text
Keywords: cardiac rehabilitation; surveys and questionnaires; international health; patient education as topic cardiac rehabilitation; surveys and questionnaires; international health; patient education as topic
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Lima de Melo Ghisi, G.; Pesah, E.; Turk-Adawi, K.; Supervia, M.; Lopez Jimenez, F.; Grace, S.L. Cardiac Rehabilitation Models around the Globe. J. Clin. Med. 2018, 7, 260.

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