Cardiac Rehabilitation Models around the Globe.

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Health Services Research

Background:

• Cardiac rehabilitation (CR) underutilization necessitates exploring alternative delivery models.
• Home- and community-based CR programs aim to improve accessibility.
• Global data on the availability and characteristics of these alternative CR models are lacking.

Purpose of the Study:

• To assess the global availability and characteristics of alternative cardiac rehabilitation delivery models.
• To identify barriers to the effective implementation of home- and community-based CR.
• To provide evidence for optimizing CR program allocation.

Main Methods:

• A global, cross-sectional study utilizing a piloted online survey.
• Survey administered to CR programs worldwide.
• Data collected from 93 countries, with 1082 surveys initiated.

Main Results:

• CR is available in 54.7% of countries; alternative models exist in 25.1% of all countries.
• Home-based CR is offered in 34.2% of countries with CR, with 63.9% incorporating electronic CR (eCR).
• Community-based CR is available in 22.5% of countries with CR; however, capacity is insufficient in 47% of home-based programs, and home-based CR dosage is often inadequate.

Conclusions:

• Alternative CR models, particularly home-based, are not universally available and face capacity challenges.
• The current dosage for home-based CR may not be sufficient for health benefits.
• Evidence-based strategies are needed for allocating patients to appropriate CR program models.