Current state of cardiac rehabilitation in Portugal: Results of the 2019 national survey

Fontes, José Paulo; Vilela, Eduardo; Durazzo, A; Teixeira, Madalena

doi:10.1016/j.repc.2021.01.013

Cited by 10 publications

(4 citation statements)

References 42 publications

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“…National survey in Portugal [20] showed that dieticians were in the CR team in 92% and psychiatrist/psychologist participated in 76% in 25 centers which were directed by cardiologists, though it was not clear whether they are dedicated to CR or part-time. Among components of CR programs, nutritional counseling was available in 100%, smoking cessation counseling in 88%, psychosocial assessment in 68%, vocational counseling 48%, sexual counseling 48%.…”

Section: Discussionmentioning

confidence: 99%

Comprehensiveness of cardiac rehabilitation program in Korea: a nation-wide survey result

Sung

Kim

Han

et al. 2023

BMC Cardiovasc Disord

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Background Cardiac rehabilitation (CR) is an essential component in secondary prevention of cardiovascular diseases. Current guidelines recommend that the program should be comprehensive including multidisciplinary behavioral intervention, not only exercise training. While the utilization of CR is gradually increasing, the comprehensiveness of the program has not been systemically evaluated in Korea. Methods During the year 2020, nation-wide survey was done to evaluate the current status of CR in Korea. Survey was done by web-based structured questionnaire. Survey was requested to 164 hospitals performing percutaneous coronary intervention. Results Among 164 hospitals, 47 (28.7%) hospitals had CR programs. In hospitals with CR, multidisciplinary intervention other than exercise-based program was provided only partially: nutritional counseling (63%), vocational counseling for return to work (39%), stress management (31%), psychological evaluation (18%). Personnel for CR was commonly not dedicated to the program or even absent: (percentage of dedicated, concurrent with other work, absent) physical therapist (59, 41, 0%), nurse (31, 69, 0%), dietician (6, 65, 29%), clinical psychologist (0, 37, 63%). Conclusion Comprehensiveness of CR in Korea is suboptimal and human resource for it is poorly disposed. More awareness of current status by both clinicians and health policy makers is needed and insurance reimbursement for educational program should be improved.

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Section: Discussionmentioning

confidence: 99%

Comprehensiveness of cardiac rehabilitation program in Korea: a nation-wide survey result

Sung

Kim

Han

et al. 2023

BMC Cardiovasc Disord

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“…This is the first study to investigate the clinical determinants and barriers to enrollment in a CR program for HFrEF patients in a tertiary hospital in Portugal. Regarding the situation of CR in Portugal and according to Fontes et al [ 22 ], 25 centers (16 public, 9 private) provide structured CR programs nationwide. All centers reported multidisciplinary teams, all of which included a cardiologist [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the situation of CR in Portugal and according to Fontes et al [ 22 ], 25 centers (16 public, 9 private) provide structured CR programs nationwide. All centers reported multidisciplinary teams, all of which included a cardiologist [ 22 ]. Regarding the number of participants, in 2019, a total of 2182 patients underwent phase II programs [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Determinants and Barriers to Cardiac Rehabilitation Enrollment of Patients with Heart Failure with Reduced Ejection Fraction: A Single-Center Study in Portugal

Alexandre

Schmidt

Campinas

et al. 2022

JCDD

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Despite cardiac rehabilitation (CR) being a recommended treatment for patients with heart failure with reduced ejection fraction (HFrEF), it is still underused. This study investigated the clinical determinants and barriers to enrollment in a CR program for HFrEF patients. We conducted a cohort study using the Cardiac Rehabilitation Barriers Scale (CRBS) to assess the reason for non-enrollment. Of 214 HFrEF patients, 65% had not been enrolled in CR. Patients not enrolled in CR programs were older (63 vs. 58 years; p < 0.01) and were more likely to have chronic obstructive pulmonary disease (COPD) (20% vs. 5%; p < 0.01). Patients enrolled in CR were more likely to be treated with sacubitril/valsartan (34% vs. 19%; p = 0.01), mineralocorticoid receptor antagonists (84% vs. 72%; p = 0.04), an implantable cardioverter defibrillator (ICD) (41% vs. 20%; p < 0.01), and cardiac resynchronization therapy (21% vs. 10%; p = 0.03). Multivariate analysis revealed that age (adjusted OR 1.04; 95% CI 1.01–1.07), higher education level (adjusted OR 3.31; 95% CI 1.63–6.70), stroke (adjusted OR 3.29; 95% CI 1.06–10.27), COPD (adjusted OR 4.82; 95% CI 1.53–15.16), and no ICD status (adjusted OR 2.68; 95% CI 1.36–5.26) were independently associated with CR non-enrollment. The main reasons for not being enrolled in CR were no medical referral (31%), concomitant medical problems (28%), patient refusal (11%), and geographical distance to the hospital (9%). Despite the relatively high proportion (35%) of HFrEF patients who underwent CR, the enrollment rate can be further improved. Innovative multi-level strategies addressing physicians’ awareness, patients’ comorbidities, and geographical issues should be pursued.

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Adherence, safety, and satisfaction of a cardio-oncology rehabilitation program framework versus community exercise training for cancer survivors: findings from the CORE trial

Viamonte

Joaquim

Alves

et al. 2023

Support Care Cancer

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Purpose To assess safety, satisfaction, and overall adherence of a center-based cardiac rehabilitation (CBCR) program for cancer survivors at increased cardiovascular (CV) risk, compared to community-based exercise training (CBET). Methods The CORE study was a single-center, prospective, randomized controlled trial enrolling cancer survivors exposed to cardiotoxic cancer treatment and/or with previous CV disease. Participants were randomized to an 8-week CBCR program or CBET, twice a week. Overall feasibility (consent, retention, and completion rates), intervention adherence (percentage of exercise sessions attended), and safety were assessed. Adverse events (AEs) were registered, and participants' satisfaction was measured at the end of the study. Results Eighty out of 116 potentially eligible individuals were included; consent rate was 72.4%, and 77 (96.2%) started the study (retention rate 100% in CBCR vs 92.5% in CBET); completion rate was 92.5%. Intervention adherence was higher in CBCR (90.3 ± 11.8% vs 68.4 ± 22.1%, p < 0.001). Exercise-related AEs were mainly related to musculoskeletal conditions in both groups (7 in CBCR vs 20 in CBET, p < 0.001), accounting for exercise prescription modification in 47 sessions (18 (3.3%) in CBCR vs 29 (7.2%) in CBET, p = 0.006), none motivating exercise discontinuation. No participants reported major CV events. Overall, the satisfaction with the different aspects of the programs (e.g., expectations, monitoring) was higher in the CBCR. Conclusion This exploratory analysis of the CORE trial suggests that both exercise-based interventions are feasible and safe in this setting. The higher intervention adherence and patient satisfaction in CBCR suggest that this comprehensive approach could be of interest in this population.

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Current state of cardiac rehabilitation in Portugal: Results of the 2019 national survey

Cited by 10 publications

References 42 publications

Comprehensiveness of cardiac rehabilitation program in Korea: a nation-wide survey result

Comprehensiveness of cardiac rehabilitation program in Korea: a nation-wide survey result

Clinical Determinants and Barriers to Cardiac Rehabilitation Enrollment of Patients with Heart Failure with Reduced Ejection Fraction: A Single-Center Study in Portugal

Adherence, safety, and satisfaction of a cardio-oncology rehabilitation program framework versus community exercise training for cancer survivors: findings from the CORE trial

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