Cardiac rehabilitation availability and delivery in Europe: How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology

Ana Abreu, Ella Pesah, Marta Supervia, Karam Turk-Adawi, Birna Bjarnason-Wehrens, Francisco Lopez-Jimenez, Marco Ambrosetti, Karl Andersen, Vojislav Giga, Dusko Vulic, Eleonora Vataman, Dan Gaita, Jacqueline Cliff, Evangelia Kouidi, Ilker Yagci, Attila Simon, Arto Hautala, Egle Tamuleviciute-Prasciene, Hareld Kemps, Zbigniew EysymonttStefan Farsky, Jo Hayward, Eva Prescott, Susan Dawkes, Bruno Pavy, Anna Kiessling, Eliska Sovova, Sherry L. Grace

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Aims: The aims of this study were to establish cardiac rehabilitation availability and density, as well as the nature of programmes, and to compare these by European region (geoscheme) and with other high-income countries. Methods: A survey was administered to cardiac rehabilitation programmes globally. Cardiac associations were engaged to facilitate programme identification. Density was computed using global burden of disease study ischaemic heart disease incidence estimates. Four high-income countries were selected for comparison (N = 790 programmes) to European data, and multilevel analyses were performed. Results: Cardiac rehabilitation was available in 40/44 (90.9%) European countries. Data were collected in 37 (94.8% country response rate). A total of 455/1538 (29.6% response rate) programme respondents initiated the survey. Programme volumes (median 300) were greatest in western European countries, but overall were higher than in other high-income countries (P < 0.001). Across all Europe, there was on average only 1 CR spot per 7 IHD patients, with an unmet regional need of 3,449,460 spots annually. Most programmes were funded by social security (n = 25, 59.5%; with significant regional variation, P < 0.001), but in 72 (16.0%) patients paid some or all of the programme costs (or ∼18.5% of the ∼€150.0/programme) out of pocket. Guideline-indicated conditions were accepted in 70% or more of programmes (lower for stable coronary disease), with no regional variation. Programmes had a multidisciplinary team of 6.5 ± 3.0 staff (number and type varied regionally; and European programmes had more staff than other high-income countries), offering 8.5 ± 1.5/10 core components (consistent with other high-income countries) over 24.8 ± 26.0 hours (regional differences, P < 0.05). Conclusion: European cardiac rehabilitation capacity must be augmented. Where available, services were consistent with guidelines, but varied regionally.

Original languageEnglish (US)
Pages (from-to)1131-1146
Number of pages16
JournalEuropean Journal of Preventive Cardiology
Volume26
Issue number11
DOIs
StatePublished - Jul 1 2019

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Cardiology
Guidelines
Multilevel Analysis
Social Security
Myocardial Ischemia
Coronary Disease
Cardiac Rehabilitation
Costs and Cost Analysis
Incidence
Surveys and Questionnaires

Keywords

  • Cardiac rehabilitation
  • Europe
  • survey

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

Cite this

Cardiac rehabilitation availability and delivery in Europe : How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology. / Abreu, Ana; Pesah, Ella; Supervia, Marta; Turk-Adawi, Karam; Bjarnason-Wehrens, Birna; Lopez-Jimenez, Francisco; Ambrosetti, Marco; Andersen, Karl; Giga, Vojislav; Vulic, Dusko; Vataman, Eleonora; Gaita, Dan; Cliff, Jacqueline; Kouidi, Evangelia; Yagci, Ilker; Simon, Attila; Hautala, Arto; Tamuleviciute-Prasciene, Egle; Kemps, Hareld; Eysymontt, Zbigniew; Farsky, Stefan; Hayward, Jo; Prescott, Eva; Dawkes, Susan; Pavy, Bruno; Kiessling, Anna; Sovova, Eliska; Grace, Sherry L.

In: European Journal of Preventive Cardiology, Vol. 26, No. 11, 01.07.2019, p. 1131-1146.

Research output: Contribution to journalArticle

Abreu, A, Pesah, E, Supervia, M, Turk-Adawi, K, Bjarnason-Wehrens, B, Lopez-Jimenez, F, Ambrosetti, M, Andersen, K, Giga, V, Vulic, D, Vataman, E, Gaita, D, Cliff, J, Kouidi, E, Yagci, I, Simon, A, Hautala, A, Tamuleviciute-Prasciene, E, Kemps, H, Eysymontt, Z, Farsky, S, Hayward, J, Prescott, E, Dawkes, S, Pavy, B, Kiessling, A, Sovova, E & Grace, SL 2019, 'Cardiac rehabilitation availability and delivery in Europe: How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology', European Journal of Preventive Cardiology, vol. 26, no. 11, pp. 1131-1146. https://doi.org/10.1177/2047487319827453
Abreu, Ana ; Pesah, Ella ; Supervia, Marta ; Turk-Adawi, Karam ; Bjarnason-Wehrens, Birna ; Lopez-Jimenez, Francisco ; Ambrosetti, Marco ; Andersen, Karl ; Giga, Vojislav ; Vulic, Dusko ; Vataman, Eleonora ; Gaita, Dan ; Cliff, Jacqueline ; Kouidi, Evangelia ; Yagci, Ilker ; Simon, Attila ; Hautala, Arto ; Tamuleviciute-Prasciene, Egle ; Kemps, Hareld ; Eysymontt, Zbigniew ; Farsky, Stefan ; Hayward, Jo ; Prescott, Eva ; Dawkes, Susan ; Pavy, Bruno ; Kiessling, Anna ; Sovova, Eliska ; Grace, Sherry L. / Cardiac rehabilitation availability and delivery in Europe : How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology. In: European Journal of Preventive Cardiology. 2019 ; Vol. 26, No. 11. pp. 1131-1146.
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abstract = "Aims: The aims of this study were to establish cardiac rehabilitation availability and density, as well as the nature of programmes, and to compare these by European region (geoscheme) and with other high-income countries. Methods: A survey was administered to cardiac rehabilitation programmes globally. Cardiac associations were engaged to facilitate programme identification. Density was computed using global burden of disease study ischaemic heart disease incidence estimates. Four high-income countries were selected for comparison (N = 790 programmes) to European data, and multilevel analyses were performed. Results: Cardiac rehabilitation was available in 40/44 (90.9{\%}) European countries. Data were collected in 37 (94.8{\%} country response rate). A total of 455/1538 (29.6{\%} response rate) programme respondents initiated the survey. Programme volumes (median 300) were greatest in western European countries, but overall were higher than in other high-income countries (P < 0.001). Across all Europe, there was on average only 1 CR spot per 7 IHD patients, with an unmet regional need of 3,449,460 spots annually. Most programmes were funded by social security (n = 25, 59.5{\%}; with significant regional variation, P < 0.001), but in 72 (16.0{\%}) patients paid some or all of the programme costs (or ∼18.5{\%} of the ∼€150.0/programme) out of pocket. Guideline-indicated conditions were accepted in 70{\%} or more of programmes (lower for stable coronary disease), with no regional variation. Programmes had a multidisciplinary team of 6.5 ± 3.0 staff (number and type varied regionally; and European programmes had more staff than other high-income countries), offering 8.5 ± 1.5/10 core components (consistent with other high-income countries) over 24.8 ± 26.0 hours (regional differences, P < 0.05). Conclusion: European cardiac rehabilitation capacity must be augmented. Where available, services were consistent with guidelines, but varied regionally.",
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T2 - How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology

AU - Abreu, Ana

AU - Pesah, Ella

AU - Supervia, Marta

AU - Turk-Adawi, Karam

AU - Bjarnason-Wehrens, Birna

AU - Lopez-Jimenez, Francisco

AU - Ambrosetti, Marco

AU - Andersen, Karl

AU - Giga, Vojislav

AU - Vulic, Dusko

AU - Vataman, Eleonora

AU - Gaita, Dan

AU - Cliff, Jacqueline

AU - Kouidi, Evangelia

AU - Yagci, Ilker

AU - Simon, Attila

AU - Hautala, Arto

AU - Tamuleviciute-Prasciene, Egle

AU - Kemps, Hareld

AU - Eysymontt, Zbigniew

AU - Farsky, Stefan

AU - Hayward, Jo

AU - Prescott, Eva

AU - Dawkes, Susan

AU - Pavy, Bruno

AU - Kiessling, Anna

AU - Sovova, Eliska

AU - Grace, Sherry L.

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