title: Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative.
abstract: The primary aim of the Million Hearts initiative is to prevent 1 million cardiovascular events over 5 years. Concordant with the Million Hearts' focus on achieving more than 70% performance in the "ABCS" of aspirin for those at risk, blood pressure control, cholesterol management, and smoking cessation, we outline the cardiovascular events that would be prevented and a road map to achieve more than 70% participation in cardiac rehabilitation (CR)/secondary prevention programs by the year 2022. Cardiac rehabilitation is a class Ia recommendation of the American Heart Association and the American College of Cardiology after myocardial infarction or coronary revascularization, promotes the ABCS along with lifestyle counseling and exercise, and is associated with decreased total mortality, cardiac mortality, and rehospitalizations. However, current participation rates for CR in the United States generally range from only 20% to 30%. This road map focuses on interventions, such as electronic medical record-based prompts and staffing liaisons that increase referrals of appropriate patients to CR, increase enrollment of appropriate individuals into CR, and increase adherence to longer-term CR. We also calculate that increasing CR participation from 20% to 70% would save 25,000 lives and prevent 180,000 hospitalizations annually in the United States.
authors.affiliation: Cardiac Rehabilitation and Prevention Program, University of Vermont College of Medicine, Burlington, VT. Electronic address: Philip.ades@uvmhealth.org.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Ades
authors.affiliation: Preventive Cardiology, Henry Ford Hospital, Detroit, MI.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Keteyian
authors.affiliation: Million Hearts, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Janet S
authors.initials: JS
authors.lastname: Wright
authors.affiliation: Clinical Exercise Physiology Program, Department of Exercise and Nutrition Sciences, George Washington University, Washington, DC.
authors.forename: Larry F
authors.initials: LF
authors.lastname: Hamm
authors.affiliation: GRQ, LLC, Vienna, VA.
authors.forename: Karen
authors.initials: K
authors.lastname: Lui
authors.affiliation: Cardiac and Pulmonary Rehabilitation, Sutter Roseville Medical Center, Roseville, CA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Newlin
authors.affiliation: Heller School for Social Policy and Management, Brandeis University, Waltham, MA.
authors.forename: Donald S
authors.initials: DS
authors.lastname: Shepard
authors.affiliation: Cardiac Rehabilitation Program, Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors.forename: Randal J
authors.initials: RJ
authors.lastname: Thomas
mesh_terms: D000572:American Heart Association; D000072038:Cardiac Rehabilitation / Q000592:standards* / Q000706:statistics & numerical data; D002487:Centers for Disease Control and Prevention, U.S.; D014487:Centers for Medicare and Medicaid Services, U.S.; D006801:Humans; D009203:Myocardial Infarction / Q000534:rehabilitation*; D009204:Myocardial Revascularization / Q000534:rehabilitation*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D055502:Secondary Prevention / Q000379:methods / Q000592:standards*; D014481:United States