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Promoting Patient Utilization of Outpatient Cardiac Rehabilitation: A JOINT INTERNATIONAL COUNCIL AND CANADIAN ASSOCIATION OF CARDIOVASCULAR PREVENTION AND REHABILITATION POSITION STATEMENT.

Santiago de Araújo Pio, C; Beckie, TM; Varnfield, M; Sarrafzadegan, N; Babu, AS; Baidya, S; Buckley, J; Chen, S-Y; Gagliardi, A; Heine, M; Khiong, JS; Mola, A; Radi, B; Supervia, M; Trani, MR; Abreu, A; Sawdon, JA; Moffatt, PD; Grace, SL

Authors

C Santiago de Araújo Pio

TM Beckie

M Varnfield

N Sarrafzadegan

AS Babu

S Baidya

S-Y Chen

A Gagliardi

M Heine

JS Khiong

A Mola

B Radi

M Supervia

MR Trani

A Abreu

JA Sawdon

PD Moffatt

SL Grace



Abstract

PURPOSE: Cardiac rehabilitation (CR) is a recommendation in international clinical practice guidelines given its benefits; however, use is suboptimal. The purpose of this position statement was to translate evidence on interventions that increase CR enrollment and adherence into implementable recommendations. METHODS: The writing panel was constituted by representatives of societies internationally concerned with preventive cardiology and included disciplines that would be implementing the recommendations. Patient partners served, as well as policy makers. The statement was developed in accordance with AGREE II, among other guideline checklists. Recommendations were based on our update of the Cochrane review on interventions to promote patients' utilization of CR. These were circulated to panel members, who were asked to rate each on a 7-point Likert scale in terms of scientific acceptability, actionability, and feasibility of assessment. A Web call was convened to achieve consensus and confirm strength of the recommendations (based on Grading of Recommendations Assessment, Development, and Evaluation [GRADE]). The draft underwent external review and public comment. RESULTS: The 3 drafted recommendations were that to increase enrollment, health care providers, particularly nurses (strong), should promote CR to patients face-to-face (strong), and that to increase adherence, part of CR could be delivered remotely (weak). Ratings (mean ± SD) for the 3 recommendations were 5.95 ± 0.69, 5.33 ± 1.12, and 5.64 ± 1.08, respectively. CONCLUSIONS: Interventions can significantly increase utilization of CR and hence should be widely applied. We call upon cardiac care institutions to implement these strategies to augment CR utilization and to ensure that CR programs are adequately resourced to serve enrolling patients and support them to complete programs.

Acceptance Date Jun 24, 2019
Publication Date Mar 1, 2020
Journal Journal of Cardiopulmonary Rehabilitation and Prevention
Print ISSN 1932-7501
Publisher Lippincott, Williams & Wilkins
Pages 79 - 86
DOI https://doi.org/10.1097/HCR.0000000000000474
Publisher URL https://journals.lww.com/jcrjournal/Abstract/2020/03000/Promoting_Patient_Utilization_of_Outpatient.4.aspx