Barriers and facilitators of cardiac rehabilitation uptake and completion in south Asian minorities: a meta-synthesis

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation is a proven modality to prevent future cardiac events and complications in cardiac patients. However, the uptake and completion rate are suboptimal in cardiac patients and even worse in ethnic minorities and women. South Asian minorities experience several barriers and facilitators to cardiac rehabilitation uptake and completion. Aim To develop a comprehensive understanding of barriers and facilitators to cardiac rehabilitation uptake and completion by South Asian minorities. Methods A meta-synthesis was conducted, and findings were reported using PRISMA guidelines. The following databases: Medline, Embase, APA PsycInfo, Cochrane Database of Systematic Review, CINHAL, Scopus, and Web of Science were searched from inception to July 2022. The inclusion criteria comprised the studies that focused on South Asian adult minorities’ barriers and/or facilitators of a structured cardiac rehabilitation program. Studies were critically appraised using the Mixed Methods Appraisal Tool. Thematic synthesis was used in the analysis. Results A total of 7110 records were retrieved and eight studies from Canada and United Kingdom met the inclusion criteria. There were more identified barriers than facilitators. Communication constraints resulted in inadequate health education, while conservative socio-religious beliefs, negative attitudes about healthcare professionals, and systemic constraints (e.g., transportation problems, and work schedule concerns) were the key barriers themes. Peer and family support and patient-preferred specific mechanisms for cardiac rehabilitation implementation were substantial facilitators. Conclusion South Asian minorities experience multilevel barriers and facilitators to cardiac rehabilitation uptake and completion. Further research with a robust and culturally contextual intervention and methodology can help improve the uptake and cardiac rehabilitation completion in this population. Healthcare professionals and policymakers can utilize these findings to develop tailored cardiac rehabilitation programs for South Asian minorities.