Cardiac rehabilitation: Unraveling the complexity of referral and current models of delivery

Astley, Carolyn M, Neubeck, Lis, Gallagher, Robyn, Berry, Narelle, Du, Huiyun, Hill, Martha N and Clark, Robyn A (2017) Cardiac rehabilitation: Unraveling the complexity of referral and current models of delivery. Journal of Cardiovascular Nursing, 32 (3). pp. 236-243. ISSN 0889-4655

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BACKGROUND: Evidence-based guidelines recommend strategies for reducing risk factors for secondary prevention of acute coronary syndromes, yet referral to and completion of programs to deliver this advice are poor.  PURPOSE: In this article we describe the complexity of factors that influence referral and delivery of evidence-based cardiac rehabilitation (CR) programs through an Australian context and provide direction for solutions for clinicians and policy makers to consider. The Ecological Approach is used as a framework to synthesize evidence. The approach has 5 categories, the characteristics of which may act as barriers and enablers to the promotion and adoption of health behaviors and includes (a) interpersonal factors, (b) interpersonal factors, (c) institutional factors, (d) community networks, and (e) public policy.  CONCLUSIONS: Despite the context of strong evidence for efficacy, this review highlights systematic flaws in the implementation of CR, an important intervention that has been shown to improve patient outcomes and prevent cardiac events. Recommendations from this review include standardization of program delivery, improvement of data capture, use of technological innovations and social networks to facilitate delivery of information and support, and establishment of a cohesive, consistent message through interorganizational collaboration involved in CR.  CLINICAL IMPLICATIONS: These avenues provide direction for potential solutions to improve the uptake of CR and secondary prevention.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine
Depositing User: Pure Connector
Date Deposited: 23 Sep 2016 23:54
Last Modified: 28 Oct 2022 08:47
DOI: 10.1097/JCN.0000000000000332

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