Cardiac rehabilitation delivery in low/middle-income countries

Babu, Abraham S (2019) Cardiac rehabilitation delivery in low/middle-income countries. Heart. pp. 1-7. ISSN 1355-6037

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Abstract

Objective cardiac rehabilitation (cr) availability,programme characteristics and barriers are not wellknown 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

Item Type: Article
Subjects: Allied Health > MCOAHS Manipal > Physiotherapy
Depositing User: KMC Library
Date Deposited: 18 Aug 2019 04:27
Last Modified: 18 Aug 2019 04:27
URI: http://eprints.manipal.edu/id/eprint/154394

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