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

Grace, SL; Turk-Adawi, KI; Contractor, A; Atrey, A; Campbell, NRC; Derman, W; Sarkar, BK; Yeo, TJ; Lopez-Jimenez, F; Buckley, J; Ghisi, GLM; Hu, D; Sarrafzadegan, N

Authors

SL Grace

KI Turk-Adawi

A Contractor

A Atrey

NRC Campbell

W Derman

BK Sarkar

TJ Yeo

F Lopez-Jimenez

GLM Ghisi

D Hu

N Sarrafzadegan



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.

Acceptance Date Aug 15, 2016
Publication Date Nov 1, 2016
Journal Progress in Cardiovascular Diseases
Print ISSN 0033-0620
Publisher Elsevier
Pages 303 - 322
DOI https://doi.org/10.1016/j.pcad.2016.08.004
Publisher URL https://www.sciencedirect.com/science/article/pii/S0033062016300810?via%3Dihub