Barriers to cardiac rehabilitation: a first national survey

Abstract

Abstract Introduction Cardiovascular diseases (CVD) are among the leading causes of morbidity and mortality worldwide. Over three quarters of the cardiovascular deaths take place in low-and middle-income countries. CVD represent half of all death in the country. Despite the benefits and clinical recommendations from ESC/AHA and WHO, Cardiac Rehabilitation (CR) is still not routinely and not universally available. Numerous studies have found that barriers to access to CR are correlated with providers, patients and environment characteristics. Purpose This first national survey on CR assesses and identifies what the main barriers to access to CR are. In addition, this study provides suggestions for the implementation of CR in the country. This study takes into consideration the recommendations of cardiologists and cardiac surgeons for further expansion of CR practice. Until 2018, no local comprehensive CR program had been realised. Nevertheless, secondary cardiovascular preventive programs such as CR are not a priority. Methods A quantitative cross-sectional study design was adopted using a structured, self-administrated questionnaire. The survey was conducted in December 2018 among cardiologists and cardiac surgeons. A 25item questionnaire was used to collect information on CR. Responses were analysed using descriptive statistics SPSS software (version 24). Results The respondents' rate was 41.5% (n=83). 77.7% of Physicians will face barriers to refer patients to a CR program. The top 3 barriers are: first “the lack of specialist”, second barrier to overcome is “the lack of patient motivation” and third “financial covering of CR”. Supplementary learning about the benefits of CR is highly recommended to enrol more patients with CVD. CR need to be covered by a insurances and government policies above all during this time of pandemic. Conclusions The role of physicians in promoting patient enrolment should be optimised and exploited in the country. The access barriers identified can help to develop CR programs and to improve CR referral and enrolment rates. Funds from private parties and a budget from the government are needed to launch new CR programs in the country. Further research is needed. Funding Acknowledgement Type of funding sources: None.