Cardiac rehabilitation delivery in low/middle-income countries

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dc.creatorElla Pesah
dc.creatorKaram Turk-Adawi
dc.creatorMarta Supervia
dc.creatorFrancisco Lopez Jimenez
dc.creatorRaquel Rodrigues Britto
dc.creatorRongjing Ding
dc.creatorAbraham Samuel Babu
dc.creatorMasoumeh Sadeghi
dc.creatorNizal Sarrafzadegan
dc.creatorLucky Cuenza
dc.creatorClaudia Victoria Anchique Santos
dc.creatorMartin Heine
dc.creatorWayne Derman
dc.creatorPaul Oh
dc.creatorSherry Grace
dc.date.accessioned2022-05-02T17:21:37Z
dc.date.accessioned2025-09-09T01:04:56Z
dc.date.available2022-05-02T17:21:37Z
dc.date.issued2019
dc.description.sponsorshipOutra Agência
dc.identifier.doihttps://heart.bmj.com/content/105/23/1806.long
dc.identifier.issn1468-201X
dc.identifier.urihttps://hdl.handle.net/1843/41294
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofHeart
dc.rightsAcesso Restrito
dc.subjectReabilitação cardíaca
dc.subjectPolíticias de saúde
dc.subjectPaíses emergentes
dc.subject.otherCardiac rehabilitation
dc.subject.otherHealth programs
dc.subject.otherLow / middle-income countries
dc.titleCardiac rehabilitation delivery in low/middle-income countries
dc.typeArtigo de periódico
local.citation.epage1812
local.citation.issue23
local.citation.spage1806
local.citation.volume105
local.description.resumoObjective: 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.
local.identifier.orcidhttps://orcid.org/ 0000-0002-4162-7761
local.identifier.orcidhttps://orcid.org/ 0000-0002-8082-7221
local.identifier.orcidhttps://orcid.org/0000-0002-9533-3654
local.identifier.orcidhttps://orcid.org/ 0000-0003-1084-0137
local.identifier.orcidhttps://orcid.org/ 0000-0001-7179-5558
local.identifier.orcidhttps://orcid.org/ 0000-0003-4131-2863
local.identifier.orcidhttps://orcid.org/ 0000-0002-8879-177X
local.identifier.orcidhttps://orcid.org/ 0000-0002-0603-6958
local.identifier.orcidhttps://orcid.org/ 0000-0001-7063-3610
local.publisher.countryBrasil
local.publisher.departmentEEF - DEPARTAMENTO DE FISIOTERAPIA
local.publisher.initialsUFMG
local.url.externahttps://heart.bmj.com/content/105/23/1806.long

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