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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

Published on: April 19, 2019

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Availability, Use, and Barriers to Cardiac Rehabilitation in LMIC

Loheetha Ragupathi1, Judy Stribling2, Yuliya Yakunina3

  • 1Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Global Heart
|March 18, 2017
PubMed

Insights

Cardiac rehabilitation (CR) is underutilized in low- and middle-income countries (LMIC). Lack of physician referral is a major barrier, necessitating targeted strategies to improve CR availability and use for secondary heart disease prevention.

Area of Science:

  • Cardiology
  • Public Health
  • Health Services Research

Background:

  • Cardiac rehabilitation (CR) is vital for secondary prevention of ischemic heart disease.
  • The burden of ischemic heart disease is high and increasing in low- and middle-income countries (LMIC).
  • Systematic data on CR availability and utilization in LMIC are lacking.

Purpose of the Study:

  • To characterize the availability, utilization, and barriers of CR in LMIC.
  • To identify gaps in peer-reviewed publications regarding CR in LMIC.

Main Methods:

  • A systematic literature search of electronic databases (Cochrane Library, EMBASE, PubMed, Web of Science) was conducted from 1980 to 2013.
  • Citations were screened for inclusion based on availability, use, and barriers to CR in LMIC.
  • Data were summarized by region/country to analyze CR characteristics and publication gaps.

Main Results:

  • 34 articles met inclusion criteria, revealing significant heterogeneity in CR availability and use across LMIC.
  • CR programs ranged from 1 (Algeria, Paraguay) to 51 (Serbia).
  • Referral rates varied (5.0% Mexico to 90.3% Lithuania), attendance rates (31.7% Bulgaria to 95.6% Lithuania) correlated with education, and lack of physician referral was the primary barrier.

Conclusions:

  • Cardiac rehabilitation is insufficiently available and underutilized in LMIC.
  • Further research is needed, particularly in Asia and Africa, to develop targeted strategies.
  • Addressing patient, physician, and system factors is crucial to overcome barriers and improve CR participation.
Abstract

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