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Access to cardiac rehabilitation: Hurdles and hopes for improvement

cardiac rehabilitation
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A new review article, published in Cardiovascular Innovations and Applications offers solutions to improve access to underutilized cardiac rehabilitation.

Consistent evidence gathered over many years supports the benefits of , including decreases in mortality and hospitalizations, and increases in quality of life. In one study of 601,099 Medicare patients older than 65 years with , five-year mortality was lower in patients who participated in cardiac rehabilitation than those who did not (16.3% versus 24.6%, respectively, P < 0.0001).

Another study has shown significantly fewer hospitalizations for among patients who participated in cardiac rehabilitation than those who did not: The patients who underwent cardiac rehabilitation had 11 admissions for a total of 41 hospitalized days over a 24-week period, whereas those who did not had 33 admissions for a total of 187 hospitalized days (P < 0.001).

The clinical benefits of cardiac rehabilitation, as documented in both young and older participants, include increased exercise capacity, energy and total quality of life.

Although cardiac rehabilitation is a class 1 indication for patients who have sustained as well as those with heart failure, it is grossly underused. In one study, only 24.4% of a cohort of 366,103 Medicare patients with a qualifying diagnosis for cardiac rehabilitation assessed from 2016 to 2017 participated in cardiac rehabilitation.

Of those who participated, only 26.9% completed the program. A closer evaluation of the barriers preventing referral, enrollment and completion of cardiac rehabilitation is needed to better understand the limitations and to promote solutions to these problems.

More information: Natalie J. Bracewell et al, Access to Cardiac Rehabilitation: Hurdles and Hopes for Improvement, Cardiovascular Innovations and Applications (2023). DOI: 10.15212/CVIA.2023.0074

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