Cardiac rehabilitation delivery model for low-resource settings

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dc.contributor.authorGrace, Sherry
dc.contributor.authorTurk-Adawi, Karam
dc.contributor.authorContractor, Aashish
dc.contributor.authorAtrey, Alison
dc.contributor.authorCampbell, Norm
dc.contributor.authorDerman, Wayne
dc.contributor.authorLima de Melo Ghisi, Gabriela
dc.contributor.authorOldridge, Neil
dc.contributor.authorSarkhar, Bidyut K.
dc.contributor.authorYeo, Tee Joo
dc.contributor.authorLopez Jimenez, Francisco
dc.contributor.authormendis, shanthi
dc.contributor.authorOh, Paul
dc.contributor.authorhu, dayi
dc.contributor.authorSarrafzadegan, Nizal
dc.date.accessioned2025-05-28T21:15:38Z
dc.date.available2025-05-28T21:15:38Z
dc.date.issued2016-05-15
dc.descriptionThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
dc.description.abstractObjective: 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 (i.e., physical activity, diet, tobacco, and mental health), (2) medical risk factor management (e.g., 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 low-resource 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 lowresource settings were summarized 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.
dc.identifier.citationGrace SL, Turk-Adawi KI, Contractor A, et al, Cardiac rehabilitation delivery model for low-resource settings, Heart 2016;102:1449-1455.
dc.identifier.issn1468-201X
dc.identifier.issn1355-6037
dc.identifier.urihttps://doi.org/10.1136/heartjnl-2015-309209
dc.identifier.urihttps://hdl.handle.net/10315/42905
dc.language.isoen
dc.publisherBMJ Publishing Group Ltd
dc.rightsAttribution-NonCommercial 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.titleCardiac rehabilitation delivery model for low-resource settings
dc.typeArticle

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