Just one in 12 ischemic heart disease patients globally can get rehab to prevent another event, according to the first-ever audit of cardiac rehabilitation around the world, undertaken by WHF Member, International Council of Cardiovascular Prevention and Rehabilitation (ICCPR). Juxtaposing audit results with estimates from the Global Burden of Disease study, it was determined that over 18 million more spots are needed every year.
Two papers reporting on the first-ever global audit and survey were published in the journal EClinicalMedicine of the Lancet family, quantifying how much rehab capacity exists in relation to need in every country of the world, and the quality of programs in countries where they do exist.
Almost half of countries in the globe have absolutely no rehab programs, according to senior author Prof. Sherry Grace of York University and University Health Network in Canada, so people will be dying unnecessarily without these programs. The region of Africa is in the greatest need of more programs; in terms of countries, India, China and Russia each need millions of more rehab spots to treat the average number of patients that develop heart disease each year currently, and it is estimated that number will grow.
The almost 6,000 programs that did exist generally met the minimum recommended standards, offering an average of 9 out of the 11 core components, but this varied by region. There was patchy delivery of interventions to stop smoking, manage stress and support return-to-work.
The two papers are a culmination of three years of effort amongst a global collaborative team of 58 investigators. The first-ever audit of cardiac rehab programs globally was undertaken in response to calls by international organizations including the World Health Organization, for implementation of preventive strategies to reduce the burden of cardiovascular disease. The study protocol was endorsed by several international organizations, including the World Heart Federation.
Professor Grace said advocacy is needed for more programs, that are reimbursed by public healthcare systems or private healthcare insurance. Increased capacity could be also be achieved by delivering more unsupervised programs – for example by exploiting technology through home-based cardiac rehabilitation, which was only offered in 38 countries. Delivery in these settings is just as effective at reducing death in heart patients.
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