Session Highlights
In this WHF Heart Café conversation, Sidney C. Smith (UNC) and Julie Redfern (Bond University) hosts with panelists Abraham Babu (Manipal), Dion Candelaria (University of Sydney) and Irene Gibson (Ireland) to launch the World Heart Federation Cardiovascular Rehabilitation Roadmap. The panel explores why cardiac rehabilitation (CR) remains underused, how to scale hybrid & tele-rehabilitation, ways to boost enrolment and completion (opt-out referrals, bedside endorsement), and how to embed CR within lifelong cardiovascular health, policy & financing, and equitable access in both HICs and LMICs.
Key takeaways
- Underuse despite Class I evidence: Awareness, workforce gaps, and perceived ROI limit referrals—especially in low-resource settings and for women and other under-represented groups.
- Make referral opt-out: Automatic (eHR/paper) referral plus clear bedside endorsement from cardiologists/surgeons increases enrolment and attendance.
- Hybrid & tele-rehab work when flexible: Combine in-person assessment with remote follow-up (phone, apps, activity trackers) and offer on-site check-ins to maximize reach, safety, and adherence.
- From “rehab program” to lifelong care: Reframe as lifelong cardiovascular health with 6–12-month check-ins, peer support, and patient empowerment rather than time-limited classes.
- Build capacity: Invest in education & standardized curricula for multidisciplinary teams (nurses, physiotherapists, exercise physiologists, dietitians, psychologists), including LMIC-ready online training.
- Models that scale: Use hub-and-spoke networks linking specialist centers to community sites; integrate CR within chronic disease management pathways (cardio-metabolic & respiratory).
- Policy & financing matter: Include CR in national strategies, benefit packages, and reimbursement; align with UN SDGs to strengthen advocacy.
- Data for value: Routine quality metrics (enrolment, completion, readmissions, risk-factor control) and registries power funding cases and continuous improvement.
- Equity by design: Co-create options for women, older adults, rural/remote and minority groups; address digital literacy and access barriers.
Who should watch?
Cardiologists, cardiac surgeons, GPs, nurses, physiotherapists, exercise physiologists, dietitians, psychologists, program managers, payers & policymakers, digital-health teams, and patient organizations working on cardiac rehabilitation, secondary prevention, and chronic disease management in both HICs and LMICs.
Cardiovascular Rehabilitation Session – FAQ
- Why is cardiac rehabilitation still underused?
- Limited awareness, workforce and funding gaps, inconvenient clinic hours, and lack of automatic referrals. Making referrals opt-out and delivering a clear bedside endorsement from treating clinicians consistently improves uptake.
- What does “hybrid” or tele-rehab look like—and is it safe?
- A flexible blend of in-person assessment plus remote follow-up (phone/video, apps, trackers) with optional on-site check-ins. Programs should monitor adherence, ensure escalation paths for higher-risk patients, and support digital literacy.
- How do we boost enrolment and completion?
- Use automatic referrals, standardized pathways, and patient-centred options (home, community, tele). Engage patients at the point of diagnosis, involve families/peers, and schedule beyond 9–5 to fit work and caregiving.
- What are proven scale-up strategies for LMICs?
- Embed CR within primary care & chronic disease programs, adopt hub-and-spoke networks, invest in online training, and secure policy and reimbursement. Collect routine outcome data to demonstrate value.