Benefits, Facilitators, and Barriers of Alternative Models of Cardiac Rehabilitation

Abstract

We conducted a systematic review of qualitative studies examining patient perspectives of cardiac rehabilitation (CR) models that use either an alternative location (ie, home-based) and/or an alternative exercise. Benefits, facilitators, and barriers were reported by patients. These insights can help improve the delivery of CR and provide new directions for research.

No transport? No worries! Cardiac telerehabilitation is a feasible and effective alternative to centre-based programs

“…In both participants and non-participants of cardiac rehabilitation, the main facilitator for remote cardiac rehabilitation was the alleviation of transport, and the main barrier was digital literacy. This view is shared by a recent qualitative systematic review on alternative cardiac rehabilitation, which confirmed peer and family support and convenience as facilitators and weather and digital literacy as barriers [ 44 ]. To overcome this digital divide, it is therefore important to upskill those wishing to attend remotely in digital literacy, co-design culturally competent services and promote wider access to digital technology [ 37 , 38 ].…”

“…To overcome this digital divide, it is therefore important to upskill those wishing to attend remotely in digital literacy, co-design culturally competent services and promote wider access to digital technology [ 37 , 38 ]. Other suggested strategies to overcome participation barriers include engaging other participants to share stories, seeking technological assistance from family and friends [ 9 ] and creating an inclement weather plan [ 44 ].…”

What's the Alternative?

“…Platz et al 6 Regarding benefits, self-efficacy and lifestyle change were reported in all 25 studies. The second most prominent category was physical or health benefits followed by psychological improvements.…”

“…Key aspects include family/peer support, sense of safety, and convenience. Taken together, the patient insights gleaned from the Platz el al 6 systematic review can provide opportunities to develop CR programming that is more accommodating, allowing increased accessibility to more individuals and improve the utilization of CR.…”

“…[3][4][5] With the goal of improving participation, alternative models of CR can serve as a unique opportunity to engage with individuals who, otherwise, would not attend traditional CR. In this issue of the Journal of Cardiopulmonary Rehabilitation and Prevention, Platz et al 6 provide the results of a systematic review of qualitative studies to capture the patient perspective of alternative forms of CR. Per the authors, an alternative model of CR was defined as a program using nontraditional forms of exercise including Wii (gaming console), tai chi, yoga, stretching, dance, qigong, aquatics, gardening, mind-body, and/or a location such as home-based, telerehabilitation, or community-based setting.…”