Heart Rehabilitation programs are only available in half of the world's countries

Every year, more than 20 million people develop heart disease worldwide, but there is only one place of cardiac rehabilitation for 12 of these patients to prevent another cardiac event, according to a new York University study . An audit and global survey of cardiac rehabilitation conducted at the York University School of Health showed that cardiac rehabilitation is only available in half of the world's countries. in need.

This first-ever audit and survey was conducted through the International Council on Cardiovascular Prevention and Rehabilitation. Heart disease is a chronic disease. Cardiac Rehabilitation provides patients with heart attacks with structured exercises, risk factor management, education and counseling to optimize their quality of life. Previous research has shown that cardiac rehabilitation reduces death and readmissions of cardiovascular origin by 20%.

Two articles reporting on the global audit and investigation were published in the journal EClinicalMedicine Lancet family today, quantifying the existing rehabilitation capacity against the needs of each country and the quality of programs in the countries where it exists. Sherry Grace, a professor at the Faculty of Health at York University, was a senior researcher with lead authors Turk-Adawi of Qatar University and Marta Supervia of the University Hospital General Gregorio Marañón.

Nearly half of the world's countries have absolutely no cardiac rehabilitation. People are dying needlessly without these programs. "

Sherry Grace, Professor, Faculty of Health, York University

The purpose of the first study was to establish the availability of cardiac rehabilitation and the ability to serve patients around the world. The global team of 58 researchers found that cardiac rehabilitation programs were available in 55% of the world's 200 or so countries. The researchers then examined all of the nearly 6,000 programs and obtained responses from 93 of the 111 countries undergoing rehabilitation. Programs reported treating fewer patients than expected each year, mainly because of lack of resources.

Previously published data from this study show that while Canada ranks among the world's best in terms of program capacity, cardiac rehabilitation is only available in the provinces, with no programs in the territories. Overall, there is only one place of cardiac rehabilitation for 4.5 patients per heart attack each year nationwide. Although Ontario has the largest number of programs, the unmet need for cardiac rehabilitation is greatest.

Africa and Southeast Asia are the regions that need the most programs. India, China and Russia were the poorest countries. everyone needs millions of extra rehabilitation places to treat the average number of patients who develop heart disease each year now, and unfortunately that number is expected to increase.

The second study presented the results of the first ever survey of cardiac rehabilitation programs in the world to determine the nature of services provided, such as types of patients served, number and type of health professionals. part of the rehabilitation teams and services. book. This study found that cardiac rehab programs are of high quality where they are available and often treat patients with chronic conditions other than heart disease.

The results showed that existing programs were generally in line with international standards and offered an average of nine of the eleven recommended core components, but this varied across regions. Interventions to quit smoking, manage stress and support return to work have been erratic; the situation is the same in Canada. The program staff consisted of an average of 6 people, usually composed of exercise professionals, nurses, dieticians and physicians.

The researchers say advocacy is needed for more programs reimbursed by public health systems or by private health insurance. "Increased capacity could also be achieved by offering more unsupervised programs – for example, by leveraging technology through home-based cardiac rehabilitation – offered in just 38 countries." Delivery in these environments is equally effective in reducing the number of deaths in heart patients "says Grace.

The protocol for this global study has been endorsed by several international organizations, including the World Heart Federation.