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dc.contributor.authorGrace, Sherry
dc.contributor.authorAlhashemi, Mohammed
dc.contributor.authorSarrafzadegan, Nizal
dc.contributor.authorSadeghi, Masoumeh
dc.contributor.authorEl-Heneidy, Asmaa
dc.contributor.authorAfaneh, Jasser
dc.contributor.authorLopez-Jimenez, Francisco
dc.contributor.authorPesah, Ella
dc.contributor.authorSupervia, Marta
dc.contributor.authorTurk-Adawi, Karam
dc.identifier.citationInternational Journal of Cardiology Vol. 285, P147-153, June 15, 2019en_US
dc.description.abstractBackground: This study aimed to (1) confirm cardiac rehabilitation (CR)availability, establish (2) CR density and unmet need, as well as (2) the nature of programs, and (3) compare these by (a) EMR country and (b) to other countries. Methods: In this cross-sectional study, a survey was administered to CR programs globally. Cardiac associations and local champions facilitated program identification. CR need was based on Global Burden of Disease study ischemic heart disease (IHD) estimates. Results: Of the 22 EMR countries, CR programs were identified in 12 (54.5%). Nine (75.0% country response rate) countries participated, and 24/49 (49.0% program response rate) surveys were initiated. There was 1 CR spot for every 104 incident IHD patients/year(versus 12globally). One-third of programs were privately funded (n=8; versus globally p<.001), and in 18 (75.0%) programs patients paid some or all of the cost out-of-pocket (versus n=378, 36.3% globally; p<.001). Over 80% of programs accepted guideline-indicated patients. Nurses (n=20, 95.2%), cardiologists (n=18, 85.7%) and dietitians (n=18, 85.7%) were the most common healthcare providers on the CR team (mean=6.4±2.2/program; 5.9±2.8 globally, p=.18). On average, programs offered 8.9±1.7/11 core components (versus 8.7±1.9 globally, p=.90). These were most commonly initial assessment, management of risk factors, and patient education (n=21, 100.0% for each), and least commonly return-to-work counselling (n=1571.4%). Mean dose was 27.0±13.5 sessions (versus 28.7±27.6 globally, p=.38).Seven (33.3%) programs offered some alternative models. Conclusion: CR is insufficiently implemented, with 2,079,283 more spots needed/year across the EMR. But where offered, CR is consistent with guidelines.en_US
dc.rightsElsevier Journals © <2019>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
dc.rightsAttribution-NoDerivatives 4.0 International*
dc.subjectcardiac rehabilitationen_US
dc.subjectEastern Mediterranean regionen_US
dc.subjecthealth servicesen_US
dc.titleAvailability and Delivery of Cardiac Rehabilitation in the Eastern Mediterranean Region: How Does it Compare Globally?en_US

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Elsevier Journals 
© <2019>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
Except where otherwise noted, this item's license is described as Elsevier Journals © <2019>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license