Nature of Cardiac Rehabilitation Around the Globe

Marta Supervia, Karam Turk-Adawi, Francisco Lopez-Jimenez, Ella Pesah, Rongjing Ding, Raquel R. Britto, Birna Bjarnason-Wehrens, Wayne Derman, Ana Abreu, Abraham S. Babu, Claudia Anchique Santos, Seng K. Jong, Lucky Cuenza, Tee Joo Yeo, Dawn Scantlebury, Karl Andersen, Graciela Gonzalez, Vojislav Giga, Dusko Vulic, Eleonora Vataman & 39 others Jacqueline Cliff, Evangelia Kouidi, Ilker Yagci, Chul Kim, Briseida Benaim, Eduardo Rivas Estany, Rosalia Fernandez, Basuni Radi, Dan Gaita, Attila Simon, Ssu Yuan Chen, Brendon Roxburgh, Juan Castillo Martin, Lela Maskhulia, Gerard Burdiat, Richard Salmon, Hermes Lomelí, Masoumeh Sadeghi, Eliska Sovova, Arto Hautala, Egle Tamuleviciute-Prasciene, Marco Ambrosetti, Lis Neubeck, Elad Asher, Hareld Kemps, Zbigniew Eysymontt, Stefan Farsky, Jo Hayward, Eva Prescott, Susan Dawkes, Claudio Santibanez, Cecilia Zeballos, Bruno Pavy, Anna Kiessling, Nizal Sarrafzadegan, Carolyn Baer, Randal Thomas, Dayi Hu, Sherry L. Grace

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models. Findings: 111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p < 0.001), dietitians (n = 739, 80.2%), and physiotherapists (n = 733, 79.3%). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8%; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2%), patient education (n = 895, 96.9%), and exercise (n = 898, 94.3%; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75% for tobacco cessation and return-to-work counseling (lower in Americas, p = < 0.05). Interpretation: This first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes.

Original languageEnglish
Pages (from-to)46-56
Number of pages11
JournalEClinicalMedicine
Volume13
DOIs
Publication statusPublished - 01-08-2019

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Tobacco Use Cessation
Benchmarking
Return to Work
Nutritionists
Physical Therapists
Risk Management
Patient Education
Percutaneous Coronary Intervention
Cardiac Rehabilitation
Coronary Artery Bypass
Tobacco
Counseling
Linear Models
Cross-Sectional Studies
Myocardial Infarction
Nurses
Guidelines
Exercise
Hypertension
Physicians

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Supervia, M., Turk-Adawi, K., Lopez-Jimenez, F., Pesah, E., Ding, R., Britto, R. R., ... Grace, S. L. (2019). Nature of Cardiac Rehabilitation Around the Globe. EClinicalMedicine, 13, 46-56. https://doi.org/10.1016/j.eclinm.2019.06.006
Supervia, Marta ; Turk-Adawi, Karam ; Lopez-Jimenez, Francisco ; Pesah, Ella ; Ding, Rongjing ; Britto, Raquel R. ; Bjarnason-Wehrens, Birna ; Derman, Wayne ; Abreu, Ana ; Babu, Abraham S. ; Santos, Claudia Anchique ; Jong, Seng K. ; Cuenza, Lucky ; Yeo, Tee Joo ; Scantlebury, Dawn ; Andersen, Karl ; Gonzalez, Graciela ; Giga, Vojislav ; Vulic, Dusko ; Vataman, Eleonora ; Cliff, Jacqueline ; Kouidi, Evangelia ; Yagci, Ilker ; Kim, Chul ; Benaim, Briseida ; Estany, Eduardo Rivas ; Fernandez, Rosalia ; Radi, Basuni ; Gaita, Dan ; Simon, Attila ; Chen, Ssu Yuan ; Roxburgh, Brendon ; Martin, Juan Castillo ; Maskhulia, Lela ; Burdiat, Gerard ; Salmon, Richard ; Lomelí, Hermes ; Sadeghi, Masoumeh ; Sovova, Eliska ; Hautala, Arto ; Tamuleviciute-Prasciene, Egle ; Ambrosetti, Marco ; Neubeck, Lis ; Asher, Elad ; Kemps, Hareld ; Eysymontt, Zbigniew ; Farsky, Stefan ; Hayward, Jo ; Prescott, Eva ; Dawkes, Susan ; Santibanez, Claudio ; Zeballos, Cecilia ; Pavy, Bruno ; Kiessling, Anna ; Sarrafzadegan, Nizal ; Baer, Carolyn ; Thomas, Randal ; Hu, Dayi ; Grace, Sherry L. / Nature of Cardiac Rehabilitation Around the Globe. In: EClinicalMedicine. 2019 ; Vol. 13. pp. 46-56.
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abstract = "Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75{\%} of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models. Findings: 111/203 (54.7{\%}) countries in the world offer CR; data were collected in 93 (83.8{\%}; N = 1082 surveys, 32.1{\%} program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4{\%}), percutaneous coronary intervention (n = 820, 96.1{\%}; 0.10), and coronary artery bypass surgery (n = 817, 95.8{\%}). Most programs were led by physicians (n = 680; 69.1{\%}). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1{\%}; low in Africa, p < 0.001), dietitians (n = 739, 80.2{\%}), and physiotherapists (n = 733, 79.3{\%}). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8{\%}; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2{\%}), patient education (n = 895, 96.9{\%}), and exercise (n = 898, 94.3{\%}; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75{\%} for tobacco cessation and return-to-work counseling (lower in Americas, p = < 0.05). Interpretation: This first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes.",
author = "Marta Supervia and Karam Turk-Adawi and Francisco Lopez-Jimenez and Ella Pesah and Rongjing Ding and Britto, {Raquel R.} and Birna Bjarnason-Wehrens and Wayne Derman and Ana Abreu and Babu, {Abraham S.} and Santos, {Claudia Anchique} and Jong, {Seng K.} and Lucky Cuenza and Yeo, {Tee Joo} and Dawn Scantlebury and Karl Andersen and Graciela Gonzalez and Vojislav Giga and Dusko Vulic and Eleonora Vataman and Jacqueline Cliff and Evangelia Kouidi and Ilker Yagci and Chul Kim and Briseida Benaim and Estany, {Eduardo Rivas} and Rosalia Fernandez and Basuni Radi and Dan Gaita and Attila Simon and Chen, {Ssu Yuan} and Brendon Roxburgh and Martin, {Juan Castillo} and Lela Maskhulia and Gerard Burdiat and Richard Salmon and Hermes Lomel{\'i} and Masoumeh Sadeghi and Eliska Sovova and Arto Hautala and Egle Tamuleviciute-Prasciene and Marco Ambrosetti and Lis Neubeck and Elad Asher and Hareld Kemps and Zbigniew Eysymontt and Stefan Farsky and Jo Hayward and Eva Prescott and Susan Dawkes and Claudio Santibanez and Cecilia Zeballos and Bruno Pavy and Anna Kiessling and Nizal Sarrafzadegan and Carolyn Baer and Randal Thomas and Dayi Hu and Grace, {Sherry L.}",
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journal = "EClinicalMedicine",
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Supervia, M, Turk-Adawi, K, Lopez-Jimenez, F, Pesah, E, Ding, R, Britto, RR, Bjarnason-Wehrens, B, Derman, W, Abreu, A, Babu, AS, Santos, CA, Jong, SK, Cuenza, L, Yeo, TJ, Scantlebury, D, Andersen, K, Gonzalez, G, Giga, V, Vulic, D, Vataman, E, Cliff, J, Kouidi, E, Yagci, I, Kim, C, Benaim, B, Estany, ER, Fernandez, R, Radi, B, Gaita, D, Simon, A, Chen, SY, Roxburgh, B, Martin, JC, Maskhulia, L, Burdiat, G, Salmon, R, Lomelí, H, Sadeghi, M, Sovova, E, Hautala, A, Tamuleviciute-Prasciene, E, Ambrosetti, M, Neubeck, L, Asher, E, Kemps, H, Eysymontt, Z, Farsky, S, Hayward, J, Prescott, E, Dawkes, S, Santibanez, C, Zeballos, C, Pavy, B, Kiessling, A, Sarrafzadegan, N, Baer, C, Thomas, R, Hu, D & Grace, SL 2019, 'Nature of Cardiac Rehabilitation Around the Globe', EClinicalMedicine, vol. 13, pp. 46-56. https://doi.org/10.1016/j.eclinm.2019.06.006

Nature of Cardiac Rehabilitation Around the Globe. / Supervia, Marta; Turk-Adawi, Karam; Lopez-Jimenez, Francisco; Pesah, Ella; Ding, Rongjing; Britto, Raquel R.; Bjarnason-Wehrens, Birna; Derman, Wayne; Abreu, Ana; Babu, Abraham S.; Santos, Claudia Anchique; Jong, Seng K.; Cuenza, Lucky; Yeo, Tee Joo; Scantlebury, Dawn; Andersen, Karl; Gonzalez, Graciela; Giga, Vojislav; Vulic, Dusko; Vataman, Eleonora; Cliff, Jacqueline; Kouidi, Evangelia; Yagci, Ilker; Kim, Chul; Benaim, Briseida; Estany, Eduardo Rivas; Fernandez, Rosalia; Radi, Basuni; Gaita, Dan; Simon, Attila; Chen, Ssu Yuan; Roxburgh, Brendon; Martin, Juan Castillo; Maskhulia, Lela; Burdiat, Gerard; Salmon, Richard; Lomelí, Hermes; Sadeghi, Masoumeh; Sovova, Eliska; Hautala, Arto; Tamuleviciute-Prasciene, Egle; Ambrosetti, Marco; Neubeck, Lis; Asher, Elad; Kemps, Hareld; Eysymontt, Zbigniew; Farsky, Stefan; Hayward, Jo; Prescott, Eva; Dawkes, Susan; Santibanez, Claudio; Zeballos, Cecilia; Pavy, Bruno; Kiessling, Anna; Sarrafzadegan, Nizal; Baer, Carolyn; Thomas, Randal; Hu, Dayi; Grace, Sherry L.

In: EClinicalMedicine, Vol. 13, 01.08.2019, p. 46-56.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Nature of Cardiac Rehabilitation Around the Globe

AU - Supervia, Marta

AU - Turk-Adawi, Karam

AU - Lopez-Jimenez, Francisco

AU - Pesah, Ella

AU - Ding, Rongjing

AU - Britto, Raquel R.

AU - Bjarnason-Wehrens, Birna

AU - Derman, Wayne

AU - Abreu, Ana

AU - Babu, Abraham S.

AU - Santos, Claudia Anchique

AU - Jong, Seng K.

AU - Cuenza, Lucky

AU - Yeo, Tee Joo

AU - Scantlebury, Dawn

AU - Andersen, Karl

AU - Gonzalez, Graciela

AU - Giga, Vojislav

AU - Vulic, Dusko

AU - Vataman, Eleonora

AU - Cliff, Jacqueline

AU - Kouidi, Evangelia

AU - Yagci, Ilker

AU - Kim, Chul

AU - Benaim, Briseida

AU - Estany, Eduardo Rivas

AU - Fernandez, Rosalia

AU - Radi, Basuni

AU - Gaita, Dan

AU - Simon, Attila

AU - Chen, Ssu Yuan

AU - Roxburgh, Brendon

AU - Martin, Juan Castillo

AU - Maskhulia, Lela

AU - Burdiat, Gerard

AU - Salmon, Richard

AU - Lomelí, Hermes

AU - Sadeghi, Masoumeh

AU - Sovova, Eliska

AU - Hautala, Arto

AU - Tamuleviciute-Prasciene, Egle

AU - Ambrosetti, Marco

AU - Neubeck, Lis

AU - Asher, Elad

AU - Kemps, Hareld

AU - Eysymontt, Zbigniew

AU - Farsky, Stefan

AU - Hayward, Jo

AU - Prescott, Eva

AU - Dawkes, Susan

AU - Santibanez, Claudio

AU - Zeballos, Cecilia

AU - Pavy, Bruno

AU - Kiessling, Anna

AU - Sarrafzadegan, Nizal

AU - Baer, Carolyn

AU - Thomas, Randal

AU - Hu, Dayi

AU - Grace, Sherry L.

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models. Findings: 111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p < 0.001), dietitians (n = 739, 80.2%), and physiotherapists (n = 733, 79.3%). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8%; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2%), patient education (n = 895, 96.9%), and exercise (n = 898, 94.3%; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75% for tobacco cessation and return-to-work counseling (lower in Americas, p = < 0.05). Interpretation: This first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes.

AB - Background: Cardiac rehabilitation (CR) is a clinically-effective but complex model of care. The purpose of this study was to characterize the nature of CR programs around the world, in relation to guideline recommendations, and compare this by World Health Organization (WHO) region. Methods: In this cross-sectional study, a piloted survey was administered online to CR programs globally. Cardiac associations and local champions facilitated program identification. Quality (benchmark of ≥ 75% of programs in a given country meeting each of 20 indicators) was ranked. Results were compared by WHO region using generalized linear mixed models. Findings: 111/203 (54.7%) countries in the world offer CR; data were collected in 93 (83.8%; N = 1082 surveys, 32.1% program response rate). The most commonly-accepted indications were: myocardial infarction (n = 832, 97.4%), percutaneous coronary intervention (n = 820, 96.1%; 0.10), and coronary artery bypass surgery (n = 817, 95.8%). Most programs were led by physicians (n = 680; 69.1%). The most common CR providers (mean = 5.9 ± 2.8/program) were: nurses (n = 816, 88.1%; low in Africa, p < 0.001), dietitians (n = 739, 80.2%), and physiotherapists (n = 733, 79.3%). The most commonly-offered core components (mean = 8.7 ± 1.9 program) were: initial assessment (n = 939, 98.8%; most commonly for hypertension, tobacco, and physical inactivity), risk factor management (n = 928, 98.2%), patient education (n = 895, 96.9%), and exercise (n = 898, 94.3%; lower in Western Pacific, p < 0.01). All regions met ≥ 16/20 quality indicators, but quality was < 75% for tobacco cessation and return-to-work counseling (lower in Americas, p = < 0.05). Interpretation: This first-ever survey of CR around the globe suggests CR quality is high. However, there is significant regional variation, which could impact patient outcomes.

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Supervia M, Turk-Adawi K, Lopez-Jimenez F, Pesah E, Ding R, Britto RR et al. Nature of Cardiac Rehabilitation Around the Globe. EClinicalMedicine. 2019 Aug 1;13:46-56. https://doi.org/10.1016/j.eclinm.2019.06.006