Cardiac rehabilitation availability and characteristics in Latin America and the Caribbean: A global comparison

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Date

2021-10

Authors

Chacin-Suarez, Audry
Grace, Sherry
Anchique-Santos, Claudia
Supervia, Marta
Turk-Adawi, Karam
Britto, Raquel
Scantlebury, Dawn
Araya-Ramirez, Felipe
GONZALEZ, GRACIELA
Benaim, Briseida

Journal Title

Journal ISSN

Volume Title

Publisher

American Heart Journal

Abstract

Background: This study aimed to establish availability and characteristics of cardiac rehabilitation (CR) in Latin America and the Caribbean (LAC), where cardiovascular disease is highly prevalent.

Methods: In this cross-sectional sub-analysis focusing on the 35 LAC countries, local cardiovascular societies identified CR programs globally. An online survey was administered to identified programs, assessing capacity and characteristics. CR need was computed relative to ischemic heart disease (IHD) incidence from the Global Burden of Disease study.

Results: ≥1 CR program was identified in 24 LAC countries (68.5% availability; median = 3 programs/country). Data were collected in 20/24 countries (83.3%); 139/255 programs responded (54.5%), and compared to responses from 1082 programs in 111 countries. LAC density was 1 CR spot per 24 IHD patients/year (vs 18 globally). Greatest need was observed in Brazil, Dominican Republic and Mexico (all with >150,000 spots needed/year). In 62.8% (vs 37.2% globally P < .001) of CR programs, patients pay out-of-pocket for some or all of CR. CR teams were comprised of a mean of 5.0 ± 2.3 staff (vs 6.0 ± 2.8 globally; P < .001); Social workers, dietitians, kinesiologists, and nurses were significantly less common on CR teams than globally. Median number of core components offered was 8 (vs 9 globally; P < .001). Median dose of CR was 36 sessions (vs 24 globally; P < .001). Only 27 (20.9%) programs offered alternative CR models (vs 31.1% globally; P < .01).

Conclusion: In LAC countries, there is very limited CR capacity in relation to need. CR dose is high, but comprehensiveness low, which could be rectified with a more multidisciplinary team.

Description

Keywords

Cardiac rehabilitation, Capacity, Density, Latin America and Caribbean region, Access, Healthcare services

Citation

Chacin-Suarez, A., Grace, S. L., Anchique-Santos, C., Supervia, M., Turk-Adawi, K., Britto, R. R., Scantlebury, D. C., Araya-Ramirez, F., Gonzalez, G., Benaim, B., Fernandez, R., Hol, J., Burdiat, G., Salmon, R., Lomeli, H., Mamataz, T., Medina-Inojosa, J. R., & Lopez-Jimenez, F. (2021). Cardiac rehabilitation availability and characteristics in Latin America and the Caribbean: A global comparison. American Heart Journal, 240, 16–27. https://doi.org/10.1016/j.ahj.2021.05.010