Impact of COVID-19's on Cardiovascular Rehabilitation Programs in Brazil: An Online Survey-Based Cross-Sectional Study
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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Iara de Sousa Cezário Jardim1, Mauricio Milani2,3, Isac Castro4
1Programa de Pós Graduação em Ciências da Reabilitação (PPGCR), Universidade de Brasília (UNB), Brasília, DF - Brasil.
Insights
The COVID-19 pandemic reduced cardiovascular rehabilitation (CR) programs in Brazil. While telerehabilitation increased, it did not fully offset the decline in CR services nationwide.
Area of Science:
- Cardiology
- Public Health
Background:
- The COVID-19 pandemic significantly disrupted healthcare services globally.
- Cardiovascular rehabilitation (CR) programs are crucial for patient recovery and secondary prevention post-cardiac events.
Purpose of the Study:
- To characterize cardiovascular rehabilitation (CR) programs in Brazil.
- To assess the impact of the initial COVID-19 wave on these programs.
- To identify strategies employed to mitigate these impacts.
Main Methods:
- A cross-sectional, retrospective study using an online survey.
- Survey participants were coordinators of CR programs across Brazil.
- Data analyzed included demographic, clinical, and operational characteristics, stratified by geographic region.
Main Results:
- Fifty-nine CR programs served 5,349 patients; only 1,817 were post-acute cardiovascular events.
- The primary impact was the suspension of on-site activities, affecting programs regardless of local COVID-19 rates.
- Most programs (75%) were temporarily interrupted, while 5% ceased operations. Programs with existing remote strategies saw increased activity via media and video calls.
Conclusions:
- The COVID-19 pandemic led to a reduction in the number of active CR programs in Brazil.
- Although telerehabilitation activities surged, this increase was insufficient to compensate for the overall decrease in CR program delivery.
- The findings highlight the vulnerability of CR services to public health crises and the need for resilient service delivery models.
Background:
The COVID-19 pandemic had an impact on cardiovascular rehabilitation (CR) programs in Brazil.
Objectives:
To describe the characteristics of CR programs in Brazil, the impacts of the first epidemiological wave of COVID-19 (first 60 days) on the programs and present the initiatives used to overcome the impacts.
Method:
This cross-sectional and retrospective study utilized a specific online survey. Participants were coordinators of CR programs. Variables were presented by Brazilian geographic region and as the following categories: demographic, clinical and operational characteristics. The significance level for statistical analysis was set at 5%.
Results:
Fifty-nine CR programs were responsible for 5,349 patients, of which only 1,817 were post-acute cardiovascular events, which corresponded to 1.99% of hospitalized patients in the month prior to the survey (n=91,231). The greatest impact was the suspension of on-site activities, which occurred similarly in areas with the highest and the lowest rates of COVID-19 in the period. Forty-five programs (75%) were shortly interrupted, while three (5%) were ended. All 42 programs that already used remote rehabilitation strategies noticed a substantial increase in activities, based primarily on the use of media and video calling. Only three (5%) considered safe to see patients during the first 60 days.
Conclusions:
There was a reduction in the number of CR programs with the COVID-19 pandemic. Telerehabilitation activities increased during the first two months of the COVID-19 pandemic, but this was not enough to overcome the reduction in CR program activities across Brazil.
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