Promoting patient utilization of outpatient cardiac rehabilitation

A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement

Carolina Santiago de Araújo Pio, Theresa M. Beckie, Marlien Varnfield, Nizal Sarrafzadegan, Abraham S. Babu, Sumana Baidya, John Buckley, Ssu Yuan Chen, Anna Gagliardi, Martin Heine, Jong Seng Khiong, Ana Mola, Basuni Radi, Marta Supervia, Maria R. Trani, Ana Abreu, John A. Sawdon, Paul D. Moffatt, Sherry L. Grace

Research output: Contribution to journalArticle

Abstract

Background: 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 enrolment 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 patient 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 GRADE). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrolment, healthcare 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 for the 3 recommendations were 5.95 ± 0.69 (mean ± standard deviation), 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 CR programs are adequately resourced to serve enrolling patients and support them to complete programs.

Original languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusAccepted/In press - 01-01-2019

Fingerprint

Outpatients
Cardiac Rehabilitation
Cardiology
Administrative Personnel
Checklist
Practice Guidelines
Health Personnel
Nurses
Guidelines

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Santiago de Araújo Pio, Carolina ; Beckie, Theresa M. ; Varnfield, Marlien ; Sarrafzadegan, Nizal ; Babu, Abraham S. ; Baidya, Sumana ; Buckley, John ; Chen, Ssu Yuan ; Gagliardi, Anna ; Heine, Martin ; Khiong, Jong Seng ; Mola, Ana ; Radi, Basuni ; Supervia, Marta ; Trani, Maria R. ; Abreu, Ana ; Sawdon, John A. ; Moffatt, Paul D. ; Grace, Sherry L. / Promoting patient utilization of outpatient cardiac rehabilitation : A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement. In: International Journal of Cardiology. 2019.
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title = "Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement",
abstract = "Background: 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 enrolment 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 patient 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 GRADE). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrolment, healthcare 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 for the 3 recommendations were 5.95 ± 0.69 (mean ± standard deviation), 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 CR programs are adequately resourced to serve enrolling patients and support them to complete programs.",
author = "{Santiago de Ara{\'u}jo Pio}, Carolina and Beckie, {Theresa M.} and Marlien Varnfield and Nizal Sarrafzadegan and Babu, {Abraham S.} and Sumana Baidya and John Buckley and Chen, {Ssu Yuan} and Anna Gagliardi and Martin Heine and Khiong, {Jong Seng} and Ana Mola and Basuni Radi and Marta Supervia and Trani, {Maria R.} and Ana Abreu and Sawdon, {John A.} and Moffatt, {Paul D.} and Grace, {Sherry L.}",
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Santiago de Araújo Pio, C, Beckie, TM, Varnfield, M, Sarrafzadegan, N, Babu, AS, Baidya, S, Buckley, J, Chen, SY, Gagliardi, A, Heine, M, Khiong, JS, Mola, A, Radi, B, Supervia, M, Trani, MR, Abreu, A, Sawdon, JA, Moffatt, PD & Grace, SL 2019, 'Promoting patient utilization of outpatient cardiac rehabilitation: A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement', International Journal of Cardiology. https://doi.org/10.1016/j.ijcard.2019.06.064

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, Carolina; Beckie, Theresa M.; Varnfield, Marlien; Sarrafzadegan, Nizal; Babu, Abraham S.; Baidya, Sumana; Buckley, John; Chen, Ssu Yuan; Gagliardi, Anna; Heine, Martin; Khiong, Jong Seng; Mola, Ana; Radi, Basuni; Supervia, Marta; Trani, Maria R.; Abreu, Ana; Sawdon, John A.; Moffatt, Paul D.; Grace, Sherry L.

In: International Journal of Cardiology, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Promoting patient utilization of outpatient cardiac rehabilitation

T2 - A joint International Council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement

AU - Santiago de Araújo Pio, Carolina

AU - Beckie, Theresa M.

AU - Varnfield, Marlien

AU - Sarrafzadegan, Nizal

AU - Babu, Abraham S.

AU - Baidya, Sumana

AU - Buckley, John

AU - Chen, Ssu Yuan

AU - Gagliardi, Anna

AU - Heine, Martin

AU - Khiong, Jong Seng

AU - Mola, Ana

AU - Radi, Basuni

AU - Supervia, Marta

AU - Trani, Maria R.

AU - Abreu, Ana

AU - Sawdon, John A.

AU - Moffatt, Paul D.

AU - Grace, Sherry L.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: 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 enrolment 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 patient 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 GRADE). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrolment, healthcare 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 for the 3 recommendations were 5.95 ± 0.69 (mean ± standard deviation), 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 CR programs are adequately resourced to serve enrolling patients and support them to complete programs.

AB - Background: 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 enrolment 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 patient 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 GRADE). The draft underwent external review and public comment. Results: The 3 drafted recommendations were that to increase enrolment, healthcare 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 for the 3 recommendations were 5.95 ± 0.69 (mean ± standard deviation), 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 CR programs are adequately resourced to serve enrolling patients and support them to complete programs.

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