Clinical Practice Guideline for Cardiac Rehabilitation in Korea

Abstract

Background Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea. Methods This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors—primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified. Results CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR. Conclusion Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Risk Factors Influencing Cyberbullying Perpetration among Middle School Students in Korea: Analysis Using the Zero-Inflated Negative Binomial Regression Model

“…Depressive symptoms were assessed using 10 items from the symptom checklist-90-Revised [ 27 ]. Each item was rated using a 4-point Likert scale ranging from 1 = “not at all” to 4 = “very strongly.” All items were reverse-coded, with higher scores thus indicating higher levels of depression (Cronbach’s alpha of 0.92 in this study).…”

Evaluation of Current Resources Available for Community-Based Cardiac Rehabilitation in Korea: A Nationwide Survey Study

“…In 2019, a highly qualified clinical practice guideline for CR tailored to the situation in Korea was published. 18 19 20 However, despite these efforts, there are only 39 medical institutions that provide CR in Korea according to a recent report, 21 which is less than that in other countries which have similar economic levels. 22 Moreover, the rate of CR participation is also very low in Korea compared to that in other countries.…”

Cardiac rehabilitation engagement and associated factors among heart failure patients: a cross-sectional study

“…Cardiac rehabilitation (CR) is a multidisciplinary, guideline-recommended, secondary prevention program that promotes exercise capacity, reduces cardiovascular risk, and improves health-related quality of life for stable heart failure patients with preserved or reduced ejection fraction [ 8 , 9 ]. The safety and effectiveness of CR have been confirmed after decades of development, and now CR is recommended by international guidelines as an important model of daily management in CHF patients [ 10 , 11 ]. Although long-term regular engagement is the premise of highly effective benefits, the majority of eligible patients were not involved in the CR changes.…”