Cardiac Rehabilitation Delivery Model for Low-Resource Settings: An International Council of Cardiovascular Prevention and Rehabilitation Consensus Statement.

Sherry L Grace, Karam I Turk-Adawi, Aashish Contractor, Alison Atrey, Norman R C Campbell, Wayne Derman, Gabriela L M Ghisi, Bidyut K Sarkar, Tee J Yeo, Francisco Lopez-Jimenez, John Buckley, Dayi Hu, Nizal Sarrafzadegan

Journal: Progress in cardiovascular diseases 2017;59(3):303-322

PMID: 27542575

Full Text on Elsevier Science View on PubMed

Abstract

Cardiovascular disease (CVD) is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be efficacious and cost-effective for secondary prevention in high-income countries. Given its affordability, CR should be more broadly implemented in middle-income countries as well. Hence, the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) convened a writing panel to recommend strategies to deliver all core CR components in low-resource settings, namely: (1) initial assessment, (2) lifestyle risk factor management (i.e., diet, tobacco, mental health), (3) medical risk factor management (lipids, blood pressure), (4) education for self-management; (5) return to work; and (6) outcome evaluation. Approaches to delivering these components in alternative, arguably lower-cost settings, such as the home, community and primary care, are provided. Recommendations on delivering each of these components where the most-responsible CR provider is a non-physician, such as an allied healthcare professional or community health care worker, are also provided.

Address: School of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; International Council of Cardiovascular Prevention and Rehabilitation. Electronic address: [email protected].; School of Health Policy and Management, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.; Rehabilitation and Sports Medicine, Sir H.N. Reliance Foundation Hospital, Raja Ram Mohan Roy Road, Mumbai, 400004, India; International Council of Cardiovascular Prevention and Rehabilitation.; Imperial College, 2 Bar Close, Stapleford, Cambridgeshire, CB22 5BY.; Libin Cardiovascular Institute of Alberta, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.; Institute of Sport & Exercise Medicine (SEM) within the Faculty of Medicine & Health Sciences at the University of Stellenbosch, Cape Town, South Africa.; School of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.; Research Division, Public Health Foundation of India, ISID Campus, Vasant Kunj, New Delhi, India.; Department of Cardiology, National University Heart Centre, 5 Lower Kent Ridge Rd, Singapore 119074.; Cardiovascular Health Clinic and Cardiometabolic Program at Mayo Clinic, Rochester, MN, USA.; Institute of Medicine, University Centre Shrewsbury, UK; International Council of Cardiovascular Prevention and Rehabilitation.; People Hospital of Peking University, 11# Xizhimen S. Ave, Beijing, 100044, China.; Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Khorram Ave, PO Box 81465-1148, Isfahan, Iran.

DOI: 10.1016/j.pcad.2016.08.004

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MeSH Terms: Cardiac Rehabilitation, Cardiovascular Diseases, Global Health, Humans, International Cooperation, Secondary Prevention