Please use this identifier to cite or link to this item: http://hdl.handle.net/1843/41294
Type: Artigo de Periódico
Title: Cardiac rehabilitation delivery in low/middle-income countries
Authors: Ella Pesah
Karam Turk-Adawi
Marta Supervia
Francisco Lopez Jimenez
Raquel Rodrigues Britto
Rongjing Ding
Abraham Samuel Babu
Masoumeh Sadeghi
Nizal Sarrafzadegan
Lucky Cuenza
Claudia Victoria Anchique Santos
Martin Heine
Wayne Derman
Paul Oh
Sherry Grace
Abstract: Objective: Cardiac rehabilitation (CR) availability, programme characteristics and barriers are not well-known in low/middle-income countries (LMICs). In this study, they were compared with high-income countries (HICs) and by CR funding source. Methods: A cross-sectional online survey was administered to CR programmes globally. Need for CR was computed using incident ischaemic heart disease (IHD) estimates from the Global Burden of Disease study. General linear mixed models were performed. Results: CR was identified in 55/138 (39.9%) LMICs; 47/55 (85.5% country response rate) countries participated and 335 (53.5% programme response) surveys were initiated. There was one CR spot for every 66 IHD patients in LMICs (vs 3.4 in HICs). CR was most often paid by patients in LMICs (n=212, 65.0%) versus government in HICs (n=444, 60.2%; p<0.001). Over 85% of programmes accepted guideline-indicated patients. Cardiologists (n=266, 89.3%), nurses (n=234, 79.6%; vs 544, 91.7% in HICs, p=0.001) and physiotherapists (n=233, 78.7%) were the most common providers on CR teams (mean=5.8±2.8/programme). Programmes offered 7.3±1.8/10 core components (vs 7.9±1.7 in HICs, p<0.01) over 33.7±30.7 sessions (significantly greater in publicly funded programmes; p<0.001). Publicly funded programmes were more likely to have social workers and psychologists on staff, and to offer tobacco cessation and psychosocial counselling. Conclusion: CR is only available in 40% of LMICs, but where offered is fairly consistent with guidelines. Governments should enact policies to reimburse CR so patients do not pay out-of-pocket.
Subject: Reabilitação cardíaca
Políticias de saúde
Países emergentes
language: eng
metadata.dc.publisher.country: Brasil
Publisher: Universidade Federal de Minas Gerais
Publisher Initials: UFMG
metadata.dc.publisher.department: EEF - DEPARTAMENTO DE FISIOTERAPIA
Rights: Acesso Restrito
metadata.dc.identifier.doi: https://heart.bmj.com/content/105/23/1806.long
URI: http://hdl.handle.net/1843/41294
Issue Date: 2019
metadata.dc.url.externa: https://heart.bmj.com/content/105/23/1806.long
metadata.dc.relation.ispartof: Heart
Appears in Collections:Artigo de Periódico

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