title: Broadening the reach of cardiac rehabilitation to rural and remote Australia.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) has an evidence base but traditional models may not readily apply to people living in rural and remote regions.
  
  
  OBJECTIVE
  : To outline published comprehensive and non-hospital based CR models used for people discharged from hospital after a cardiac event that have potential relevance to those living in rural and remote areas in Australia.
  
  
  METHODS
  The PubMed database was searched using Medical subject headings (MeSH) terms and the key word 'cardiac rehabilitation' limited to clinical trials. Articles were retrieved if they included at least two components of CR and were not based in an outpatient setting.
  
  
  RESULTS
  No CR models specifically developed for rural and remote areas were identified. However, 14 studies were found that outlined 11 non-conventional comprehensive CR models. All provided CR in a home-based setting. Health professionals provided support via telephone contact or home visits, and via resources such as the Heart Manual. Reported outcomes from these CR programs varied: ranging from an increase in knowledge of risk factors, to improvements in physical activity, decreased risk factor profile, improved psychological and social functioning and reductions in health service costs and mortality.
  
  
  CONCLUSIONS
  Home-based, CR models have the most substantive evidence base and, therefore the greatest potential to be developed and made accessible to eligible people living in rural and remote areas.
authors.affiliation: Spencer Gulf Rural Health School, University of South Autralia - Whyalla Campus, Nicolson Avenue, Whyalla Norrie, SA 5608, Australia. Joanne.Dollard@unisa.edu.au
authors.forename: Joanne
authors.initials: J
authors.lastname: Dollard
authors.forename: Jacquie
authors.initials: J
authors.lastname: Smith
authors.forename: David
authors.initials: D
authors.lastname: R Thompson
authors.forename: Simon
authors.initials: S
authors.lastname: Stewart
mesh_terms: D000203:Activities of Daily Living; D001315:Australia; D003159:Community-Institutional Relations; D018450:Disease Progression; D019317:Evidence-Based Medicine; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research; D006331:Heart Diseases / Q000534:rehabilitation*; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D008507:Medically Underserved Area; D017146:Models, Organizational; D020380:Needs Assessment / Q000458:organization & administration; D012107:Research Design; D012307:Risk Factors; D019035:Rural Health Services / Q000458:organization & administration*; D012944:Social Support