Evaluation of Cardiac Rehabilitation Performance and Initial Benchmarks for Australia: An Observational Cross-State and Territory Snapshot Study

Gallagher, Robyn; Ferry, C.H.; Candelaria, Dion; Ladak, Laila Akbar; Zecchin, R

doi:10.1016/j.hlc.2020.01.010

Cited by 11 publications

(9 citation statements)

References 30 publications

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“…76.9% versus SA: 73.9% and Low-Aust. : 5.1% versus SA: 13%) (Table 5 ) [ 37 ]. Comparing South Australian (SA) program performance scores with the United Kingdom (UK) (6), showed more programs in the middle/medium category (SA: 73.9% versus UK: 45.9%) and SA showing zero poor performance programs compared to the UK’s 5.3%, but the UK showing more programs in the high performance category (UK: 30.6% versus SA: 13.0%) (Table 4 ).…”

Section: Discussionmentioning

confidence: 99%

Assessing the quality of cardiac rehabilitation programs by measuring adherence to the Australian quality indicators

Astley

Beleigoli

Tavella

et al. 2022

BMC Health Serv Res

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Background Every year, over 65,000 Australians experience an acute coronary syndrome (ACS) and around one-third occur in people with prior coronary heart disease. Cardiac rehabilitation (CR) aims to prevent a repeat ACS by supporting patients’ return to an active and fulfilling lifestyle. CR programs are efficacious, but audits of clinical practice show variability of program delivery, which may compromise patient outcomes. Core components, quality indicators and accreditation of programs have been introduced internationally to increase program standardisation. With Australian quality indicators (QIs) for cardiac rehabilitation recently introduced, we aimed to conduct a survey in one state of Australia to assess the extent to which programs adhere to the measurement of QIs comparing country, metropolitan, telephone and face to face programs. Methods A cross- sectional survey design with face validity testing was used to formulate questions to evaluate cardiac rehabilitation program and personnel characteristics and QI adherence. Between October 2020- December 2021, 23 cardiac rehabilitation programs across country and metropolitan areas were invited to participate. Quality improvement was defined as adherence to the Australian Quality Indicators, and we developed an objective score to calculate program performance categorised by quartiles. Significance of CR completion and time to enrolment between program type (telephone versus face to face) and location (country versus metropolitan were compared using Pearson’s Chi-square and Mann–Whitney U tests. Results Among the 23 CR programs, 15 were country and 8 metropolitan-based and 22 were face to face and 1 telephone-based. Median wait time from discharge was 27.0 days, (interquartile range 19.3–46.0) across all programs and country completions of enrolled were 76.9% versus metropolitan 56.5%, p < 0.001 and telephone versus face to face 92.9% versus 59.6% p < 0.001. Pre-program QI adherence was higher than post program for depression, medication adherence, health-related quality of life and comprehensive re-assessment. Seventy four percent of programs were ranked at a medium level of performance (mean score: 11.4/16, SD ± 0.79). Conclusions A survey of 23 cardiac rehabilitation programs, showed variability in adherence to measurement of the Australian Cardiovascular and Rehabilitation Association and Australian Heart Foundation Cardiac Rehabilitation Quality Indicators. Trial registration Australia New Zealand Clinical Trials Registry (ANZCTR), ACTRN12621000222842, registered 03/03/2021.

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Section: Discussionmentioning

confidence: 99%

Assessing the quality of cardiac rehabilitation programs by measuring adherence to the Australian quality indicators

Astley

Beleigoli

Tavella

et al. 2022

BMC Health Serv Res

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“… 38 Shorter wait time to starting CR programmes also provides more opportunities for patients to achieve exercise benefits, and increases motivation to make lifestyle changes. 38 Wait time is influenced by multiple provider factors such as the availability of resources including capacity that influences class size, number of available classes, equipment, and staffing 39 but can also reflect patient readiness and capacity to attend.…”

Section: Discussionmentioning

confidence: 99%

Remote-delivered cardiac rehabilitation during COVID-19: a prospective cohort comparison of health-related quality of life outcomes and patient experiences

Candelaria

Kirkness

Farrell

et al. 2022

European Journal of Cardiovascular Nursing

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Aims Enforced suspension and reduction of in-person cardiac rehabilitation (CR) services during the coronavirus disease-19 (COVID-19) pandemic restrictions required rapid implementation of remote delivery methods, thus enabling a cohort comparison of in-person vs. remote-delivered CR participants. This study aimed to examine the health-related quality of life (HRQL) outcomes and patient experiences comparing these delivery modes. Methods and results Participants across four metropolitan CR sites receiving in-person (December 2019 to March 2020) or remote-delivered (April to October 2020) programmes were assessed for HRQL (Short Form-12) at CR entry and completion. A General Linear Model was used to adjust for baseline group differences and qualitative interviews to explore patient experiences. Participants (n = 194) had a mean age of 65.94 (SD 10.45) years, 80.9% males. Diagnoses included elective percutaneous coronary intervention (40.2%), myocardial infarction (33.5%), and coronary artery bypass grafting (26.3%). Remote-delivered CR wait times were shorter than in-person [median 14 (interquartile range, IQR 10–21) vs. 25 (IQR 16–38) days, P < 0.001], but participation by ethnic minorities was lower (13.6% vs. 35.2%, P < 0.001). Remote-delivered CR participants had equivalent benefits to in-person in all HRQL domains but more improvements than in-person in Mental Health, both domain [mean difference (MD) 3.56, 95% confidence interval (CI) 1.28, 5.82] and composite (MD 2.37, 95% CI 0.15, 4.58). From qualitative interviews (n = 16), patients valued in-person CR for direct exercise supervision and group interactions, and remote-delivered for convenience and flexibility (negotiable contact times). Conclusion Remote-delivered CR implemented during COVID-19 had equivalent, sometimes better, HRQL outcomes than in-person, and shorter wait times. Participation by minority groups in remote-delivered modes are lower. Further research is needed to evaluate other patient outcomes.

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“…The completion rates among those who started CR was lower during COVID (75.4% vs 42.4%) despite similar waiting times between the two periods for both modes of delivery. A 3-month audit of CR services in other Australian regions (New South Wales, Tasmania and ACT) pre-COVID-19 showed lower completion rates (59.1%) and lower waiting times (15 days vs 28 days) than ours [ 38 ]. Internationally, the national audit of 170 British services showed higher completion rates (83%) and higher (38–50 vs 28 days) waiting times than ours regardless of the period of our study [ 39 ].…”

Section: Discussionmentioning

confidence: 71%

The Impact of the SARS-CoV-2 Virus (COVID-19) Pandemic and the Rapid Adoption of Telehealth for Cardiac Rehabilitation and Secondary Prevention Programs in Rural and Remote Australia: A Multi-Method Study

Champion

Clark²,

Tirimacco³

et al. 2022

Heart, Lung and Circulation

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Evaluation of Cardiac Rehabilitation Performance and Initial Benchmarks for Australia: An Observational Cross-State and Territory Snapshot Study

Cited by 11 publications

References 30 publications

Assessing the quality of cardiac rehabilitation programs by measuring adherence to the Australian quality indicators

Assessing the quality of cardiac rehabilitation programs by measuring adherence to the Australian quality indicators

Remote-delivered cardiac rehabilitation during COVID-19: a prospective cohort comparison of health-related quality of life outcomes and patient experiences

The Impact of the SARS-CoV-2 Virus (COVID-19) Pandemic and the Rapid Adoption of Telehealth for Cardiac Rehabilitation and Secondary Prevention Programs in Rural and Remote Australia: A Multi-Method Study

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