title: Cardiac Rehabilitation Delivery Model for Low-Resource Settings: An International Council of Cardiovascular Prevention and Rehabilitation Consensus Statement.
abstract: Cardiovascular disease (CVD) is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be efficacious and cost-effective for secondary prevention in high-income countries. Given its affordability, CR should be more broadly implemented in middle-income countries as well. Hence, the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) convened a writing panel to recommend strategies to deliver all core CR components in low-resource settings, namely: (1) initial assessment, (2) lifestyle risk factor management (i.e., diet, tobacco, mental health), (3) medical risk factor management (lipids, blood pressure), (4) education for self-management; (5) return to work; and (6) outcome evaluation. Approaches to delivering these components in alternative, arguably lower-cost settings, such as the home, community and primary care, are provided. Recommendations on delivering each of these components where the most-responsible CR provider is a non-physician, such as an allied healthcare professional or community health care worker, are also provided.
authors.affiliation: School of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada; International Council of Cardiovascular Prevention and Rehabilitation. Electronic address: sgrace@yorku.ca.
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
authors.affiliation: School of Health Policy and Management, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
authors.forename: Karam I
authors.initials: KI
authors.lastname: Turk-Adawi
authors.affiliation: Rehabilitation and Sports Medicine, Sir H.N. Reliance Foundation Hospital, Raja Ram Mohan Roy Road, Mumbai, 400004, India; International Council of Cardiovascular Prevention and Rehabilitation.
authors.forename: Aashish
authors.initials: A
authors.lastname: Contractor
authors.affiliation: Imperial College, 2 Bar Close, Stapleford, Cambridgeshire, CB22 5BY.
authors.forename: Alison
authors.initials: A
authors.lastname: Atrey
authors.affiliation: Libin Cardiovascular Institute of Alberta, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
authors.forename: Norman R C
authors.initials: NR
authors.lastname: Campbell
authors.affiliation: Institute of Sport & Exercise Medicine (SEM) within the Faculty of Medicine & Health Sciences at the University of Stellenbosch, Cape Town, South Africa.
authors.forename: Wayne
authors.initials: W
authors.lastname: Derman
authors.affiliation: School of Kinesiology and Health Science, Bethune 368, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada.
authors.forename: Gabriela L M
authors.initials: GL
authors.lastname: Ghisi
authors.affiliation: Research Division, Public Health Foundation of India, ISID Campus, Vasant Kunj, New Delhi, India.
authors.forename: Bidyut K
authors.initials: BK
authors.lastname: Sarkar
authors.affiliation: Department of Cardiology, National University Heart Centre, 5 Lower Kent Ridge Rd, Singapore 119074.
authors.forename: Tee J
authors.initials: TJ
authors.lastname: Yeo
authors.affiliation: Cardiovascular Health Clinic and Cardiometabolic Program at Mayo Clinic, Rochester, MN, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
authors.affiliation: Institute of Medicine, University Centre Shrewsbury, UK; International Council of Cardiovascular Prevention and Rehabilitation.
authors.forename: John
authors.initials: J
authors.lastname: Buckley
authors.affiliation: People Hospital of Peking University, 11# Xizhimen S. Ave, Beijing, 100044, China.
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
authors.affiliation: Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Khorram Ave, PO Box 81465-1148, Isfahan, Iran.
authors.forename: Nizal
authors.initials: N
authors.lastname: Sarrafzadegan
mesh_terms: D000072038:Cardiac Rehabilitation / Q000379:methods*; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D014943:Global Health; D006801:Humans; D007391:International Cooperation; D055502:Secondary Prevention / Q000458:organization & administration
keywords: Cardiac rehabilitation; Community health; Delivery models; Middle-income countries; Primary care