Abstract P120: Feasibility of Cardiac Rehabilitation in Resource Limited Settings

Abstract

Background: Heart failure (HF) is a growing driver of morbidity and mortality worldwide. Cardiac rehabilitation in HF improves functional status, quality of life, and depression. Global access to cardiac rehabilitation remains poor, and adherence rates are low. Methods: We implemented and assessed adherence rates associated with two models of cardiac rehabilitation in Western Kenya. One hundred participants with HF were prospectively enrolled. Choice of rehabilitation model was based on participant preference. Twenty-five participants opted to participate in 36 institution-based sessions (IBCR). Thirty-one participants enrolled into home-based sessions (HBCR). HBCR comprised 12 weekly pedometer step targets. Forty-four participants were later enrolled into an observational arm (OA). We hypothesized that participants would adhere to at least 25% of prescribed sessions. We secondarily compared changes in 6-minute walk time distance (6MWTD), depression screening (PHQ9) and quality of life (SF36) scores using a paired t-test. Results: The mean age of participants was 51 years, of whom 73 were female. Rehabilitation participants preferred institution based rehabilitation. Both study arms were adherent to the prescribed protocol as shown in figure 1. All study arms demonstrated significant improvement in 6MWTD, PHQ9 and SF36 scores. Conclusions: IBCR and HBCR, are feasible rehabilitation models for HF in this setting. Adherence rates attained in both models are higher than those seen in many developed countries. Although our results demonstrate feasibility, future research should focus on methods to further improve adherence as well evaluate efficacy of cardiac rehabilitation in this setting.