TY - JOUR
T1 - Cardiac rehabilitation availability and delivery in Europe
T2 - How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology
AU - Abreu, Ana
AU - Pesah, Ella
AU - Supervia, Marta
AU - Turk-Adawi, Karam
AU - Bjarnason-Wehrens, Birna
AU - Lopez-Jimenez, Francisco
AU - Ambrosetti, Marco
AU - Andersen, Karl
AU - Giga, Vojislav
AU - Vulic, Dusko
AU - Vataman, Eleonora
AU - Gaita, Dan
AU - Cliff, Jacqueline
AU - Kouidi, Evangelia
AU - Yagci, Ilker
AU - Simon, Attila
AU - Hautala, Arto
AU - Tamuleviciute-Prasciene, Egle
AU - Kemps, Hareld
AU - Eysymontt, Zbigniew
AU - Farsky, Stefan
AU - Hayward, Jo
AU - Prescott, Eva
AU - Dawkes, Susan
AU - Pavy, Bruno
AU - Kiessling, Anna
AU - Sovova, Eliska
AU - Grace, Sherry L
PY - 2019/7
Y1 - 2019/7
N2 - AIMS: The aims of this study were to establish cardiac rehabilitation availability and density, as well as the nature of programmes, and to compare these by European region (geoscheme) and with other high-income countries.METHODS: A survey was administered to cardiac rehabilitation programmes globally. Cardiac associations were engaged to facilitate programme identification. Density was computed using global burden of disease study ischaemic heart disease incidence estimates. Four high-income countries were selected for comparison (N = 790 programmes) to European data, and multilevel analyses were performed.RESULTS: Cardiac rehabilitation was available in 40/44 (90.9%) European countries. Data were collected in 37 (94.8% country response rate). A total of 455/1538 (29.6% response rate) programme respondents initiated the survey. Programme volumes (median 300) were greatest in western European countries, but overall were higher than in other high-income countries (P < 0.001). Across all Europe, there was on average only 1 CR spot per 7 IHD patients, with an unmet regional need of 3,449,460 spots annually. Most programmes were funded by social security (n = 25, 59.5%; with significant regional variation, P < 0.001), but in 72 (16.0%) patients paid some or all of the programme costs (or ∼18.5% of the ∼€150.0/programme) out of pocket. Guideline-indicated conditions were accepted in 70% or more of programmes (lower for stable coronary disease), with no regional variation. Programmes had a multidisciplinary team of 6.5 ± 3.0 staff (number and type varied regionally; and European programmes had more staff than other high-income countries), offering 8.5 ± 1.5/10 core components (consistent with other high-income countries) over 24.8 ± 26.0 hours (regional differences, P < 0.05).CONCLUSION: European cardiac rehabilitation capacity must be augmented. Where available, services were consistent with guidelines, but varied regionally.
AB - AIMS: The aims of this study were to establish cardiac rehabilitation availability and density, as well as the nature of programmes, and to compare these by European region (geoscheme) and with other high-income countries.METHODS: A survey was administered to cardiac rehabilitation programmes globally. Cardiac associations were engaged to facilitate programme identification. Density was computed using global burden of disease study ischaemic heart disease incidence estimates. Four high-income countries were selected for comparison (N = 790 programmes) to European data, and multilevel analyses were performed.RESULTS: Cardiac rehabilitation was available in 40/44 (90.9%) European countries. Data were collected in 37 (94.8% country response rate). A total of 455/1538 (29.6% response rate) programme respondents initiated the survey. Programme volumes (median 300) were greatest in western European countries, but overall were higher than in other high-income countries (P < 0.001). Across all Europe, there was on average only 1 CR spot per 7 IHD patients, with an unmet regional need of 3,449,460 spots annually. Most programmes were funded by social security (n = 25, 59.5%; with significant regional variation, P < 0.001), but in 72 (16.0%) patients paid some or all of the programme costs (or ∼18.5% of the ∼€150.0/programme) out of pocket. Guideline-indicated conditions were accepted in 70% or more of programmes (lower for stable coronary disease), with no regional variation. Programmes had a multidisciplinary team of 6.5 ± 3.0 staff (number and type varied regionally; and European programmes had more staff than other high-income countries), offering 8.5 ± 1.5/10 core components (consistent with other high-income countries) over 24.8 ± 26.0 hours (regional differences, P < 0.05).CONCLUSION: European cardiac rehabilitation capacity must be augmented. Where available, services were consistent with guidelines, but varied regionally.
U2 - 10.1177/2047487319827453
DO - 10.1177/2047487319827453
M3 - Journal article
C2 - 30782007
SN - 2047-4873
VL - 26
SP - 1131
EP - 1146
JO - European journal of preventive cardiology
JF - European journal of preventive cardiology
IS - 11
ER -