Cardiac rehabilitation delivery model for low-resource settings

Sherry L. Grace, Karam I. Turk-Adawi, Aashish Contractor, Alison Atrey, Norm Campbell, Wayne Derman, Gabriela L. Melo Ghisi, Neil Oldridge, Bidyut K. Sarkar, Tee Joo Yeo, Francisco Lopez-Jimenez, Shanthi Mendis, Paul Oh, Dayi Hu, Nizal Sarrafzadegan

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Objective Cardiovascular disease is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be cost-effective and efficacious in high-income countries. CR could represent an important approach to mitigate the epidemic of cardiovascular disease in lower-resource settings. The purpose of this consensus statement was to review low-cost approaches to delivering the core components of CR, to propose a testable model of CR which could feasibly be delivered in middle-income countries. Methods A literature review regarding delivery of each core CR component, namely: (1) lifestyle risk factor management (ie, physical activity, diet, tobacco and mental health), (2) medical risk factor management (eg, lipid control, blood pressure control), (3) education for self-management and (4) return to work, in low-resource settings was undertaken. Recommendations were developed based on identified articles, using a modified GRADE approach where evidence in a low-resource setting was available, or consensus where evidence was not. Results Available data on cost of CR delivery in lowresource settings suggests it is not feasible to deliver CR in low-resource settings as is delivered in high-resource ones. Strategies which can be implemented to deliver all of the core CR components in low-resource settings were summarised in practice recommendations, and approaches to patient assessment proffered. It is suggested that CR be adapted by delivery by nonphysician healthcare workers, in non-clinical settings. Conclusions Advocacy to achieve political commitment for broad delivery of adapted CR services in low-resource settings is needed.

Original languageEnglish (US)
JournalHeart
DOIs
StateAccepted/In press - May 15 2016

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Risk Management
Costs and Cost Analysis
Consensus
Cardiovascular Diseases
Cardiac Rehabilitation
Return to Work
Self Care
Tobacco
Life Style
Mental Health
Exercise
Diet
Blood Pressure
Delivery of Health Care
Lipids
Education

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Grace, S. L., Turk-Adawi, K. I., Contractor, A., Atrey, A., Campbell, N., Derman, W., ... Sarrafzadegan, N. (Accepted/In press). Cardiac rehabilitation delivery model for low-resource settings. Heart. https://doi.org/10.1136/heartjnl-2015-309209

Cardiac rehabilitation delivery model for low-resource settings. / Grace, Sherry L.; Turk-Adawi, Karam I.; Contractor, Aashish; Atrey, Alison; Campbell, Norm; Derman, Wayne; Melo Ghisi, Gabriela L.; Oldridge, Neil; Sarkar, Bidyut K.; Yeo, Tee Joo; Lopez-Jimenez, Francisco; Mendis, Shanthi; Oh, Paul; Hu, Dayi; Sarrafzadegan, Nizal.

In: Heart, 15.05.2016.

Research output: Contribution to journalArticle

Grace, SL, Turk-Adawi, KI, Contractor, A, Atrey, A, Campbell, N, Derman, W, Melo Ghisi, GL, Oldridge, N, Sarkar, BK, Yeo, TJ, Lopez-Jimenez, F, Mendis, S, Oh, P, Hu, D & Sarrafzadegan, N 2016, 'Cardiac rehabilitation delivery model for low-resource settings', Heart. https://doi.org/10.1136/heartjnl-2015-309209
Grace SL, Turk-Adawi KI, Contractor A, Atrey A, Campbell N, Derman W et al. Cardiac rehabilitation delivery model for low-resource settings. Heart. 2016 May 15. https://doi.org/10.1136/heartjnl-2015-309209
Grace, Sherry L. ; Turk-Adawi, Karam I. ; Contractor, Aashish ; Atrey, Alison ; Campbell, Norm ; Derman, Wayne ; Melo Ghisi, Gabriela L. ; Oldridge, Neil ; Sarkar, Bidyut K. ; Yeo, Tee Joo ; Lopez-Jimenez, Francisco ; Mendis, Shanthi ; Oh, Paul ; Hu, Dayi ; Sarrafzadegan, Nizal. / Cardiac rehabilitation delivery model for low-resource settings. In: Heart. 2016.
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AU - Derman, Wayne

AU - Melo Ghisi, Gabriela L.

AU - Oldridge, Neil

AU - Sarkar, Bidyut K.

AU - Yeo, Tee Joo

AU - Lopez-Jimenez, Francisco

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