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Cardiac Rehabilitation Models around the Globe

Cardiovascular Prevention and Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON M5G2A2, Canada
School of Kinesiology and Health Science, York University, Toronto, ON M3J1P3, Canada
Public Health Department, College of Health Sciences, Qatar University, Al Jamiaa St, Doha, P.O. Box 2713, Qatar
Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, 28007 Madrid, Spain
Mayo Clinic, Rochester, MN 55905, USA
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(9), 260;
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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MDPI and ACS Style

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.

AMA Style

Lima de Melo Ghisi G, Pesah E, Turk-Adawi K, Supervia M, Lopez Jimenez F, Grace SL. Cardiac Rehabilitation Models around the Globe. Journal of Clinical Medicine. 2018; 7(9):260.

Chicago/Turabian Style

Lima de Melo Ghisi, Gabriela, Ella Pesah, Karam Turk-Adawi, Marta Supervia, Francisco Lopez Jimenez, and Sherry L. Grace. 2018. "Cardiac Rehabilitation Models around the Globe" Journal of Clinical Medicine 7, no. 9: 260.

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