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dc.contributor.authorGrace, Sherry
dc.contributor.authorOh, Paul
dc.contributor.authorDerman, Wayne
dc.contributor.authorHeine, Martin
dc.contributor.authorSantos, Claudia Anchique
dc.contributor.authorCuenza, Lucky
dc.contributor.authorSarrafzadegan, Nizal
dc.contributor.authorSadeghi, Masoumeh
dc.contributor.authorBabu, Abraham
dc.contributor.authorDing, Rongjing
dc.contributor.authorBritto, Raquel
dc.contributor.authorLopez-Jimenez, Francisco
dc.contributor.authorSupervia, Marta
dc.contributor.authorTurk-Adawi, Karam
dc.contributor.authorPesah, Ella
dc.date.accessioned2021-05-10T14:37:56Z
dc.date.available2021-05-10T14:37:56Z
dc.date.issued2019-12
dc.identifier.citationHeart December 2019 - Volume 105 - 23en_US
dc.identifier.issn1355-6037
dc.identifier.urihttp://dx.doi.org/10.1136/heartjnl-2018-314486en_US
dc.identifier.urihttp://hdl.handle.net/10315/38312
dc.description.abstractObjective Cardiac rehabilitation (CR) availability, programme characteristics and barriers are not well-known 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.en_US
dc.language.isoenen_US
dc.publisherBMJen_US
dc.rightsBMJ Journals See here for full instructions. This article has been accepted for publication in [Heart, 2019] following peer review, and the Version of Record can be accessed online at [http://dx.doi.org/10.1136/heartjnl-2018-314486]. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non-Commercial 4.0 International (CC-BY-NC 4.0).en_US
dc.rightsAttribution-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nd/4.0/*
dc.subjectcardiac rehabilitationen_US
dc.subjecthealth policyen_US
dc.subjectmyocardial infarctionen_US
dc.titleCardiac rehabilitation delivery in low/middle-income countriesen_US
dc.typeArticleen_US
dc.rights.journalhttps://heart.bmj.com/en_US
dc.rights.publisherhttps://journals.bmj.com/en_US
dc.rights.articlehttps://heart.bmj.com/content/105/23/1806en_US


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BMJ Journals See here for full instructions. 
This article has been accepted for publication in [Heart, 2019] following peer review, and the Version of Record can be accessed online at 
[http://dx.doi.org/10.1136/heartjnl-2018-314486]. Reuse of this manuscript version 
(excluding any databases, tables, diagrams, photographs and other images or illustrative material included where another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non-Commercial 4.0 International (CC-BY-NC 4.0).
Except where otherwise noted, this item's license is described as BMJ Journals See here for full instructions. This article has been accepted for publication in [Heart, 2019] following peer review, and the Version of Record can be accessed online at [http://dx.doi.org/10.1136/heartjnl-2018-314486]. Reuse of this manuscript version (excluding any databases, tables, diagrams, photographs and other images or illustrative material included where another copyright owner is identified) is permitted strictly pursuant to the terms of the Creative Commons Attribution-Non-Commercial 4.0 International (CC-BY-NC 4.0).