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Cardiac Rehabilitation Services in Low-and Middle-Income Countries: A Scoping Review

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Date

2014-09

Authors

Grace, Sherry
Jiang, Xiaolian
Perez-Terzic, Carmen
Shanmugasegaram, Shamila

Journal Title

Journal ISSN

Volume Title

Publisher

Wolters Kluwer

Abstract

Background: Despite the decreasing rate of cardiovascular disease-related mortality in developed nations, low-and middle-income countries (LMICs) are experiencing an increase. Cardiac rehabilitation (CR) successfully addresses this burden, however the availability and nature of CR service delivery in LMICs is not well-known. Objective: This scoping review examined: (1) presence and accessibility of CR services, (2) structure of CR services, and (3) effects of CR on patient outcomes in LMICs. Methods: Search criteria consisted of: (1) nations considered to be low-or middle-income according to World Bank criteria, (2) CR, defined as programs including exercise and education, and (3) adults with cardiovascular diseases. Literature was identified through searching: (a) MEDLINE and EMBASE electronic databases, (b) proceedings from international cardiac conferences, (c) the grey literature, and (d) through consulting experts in the field. Results: Thirty peer-reviewed publications were identified. Grey literature including websites for individual CR programs revealed that CR is available in 32 (22.1%) LMICs. The most comprehensive data on accessibility stems from Latin America and the Caribbean, where56% of institutions with cardiac catheterization facilities offered CR. Literature showed that some programs offered exercise, dietary advice, education and psychological support, to assist patients to resume work and other activities of daily living. Fifteen peer-reviewed studies reported on CR outcomes; most of which were positive. Conclusion: Although patients similarly benefit from CR, few programs are available in LMICs. Policies need to be implemented to increase provision of tailored CR models at the global and national level, with evaluation.

Description

Keywords

cardiac rehabilitation, low- and middle-income countries

Citation

The Journal of Cardiovascular Nursing: September/October 2014 - Volume 29 - Issue 5 - p 454-463