期刊
HEART LUNG AND CIRCULATION
卷 30, 期 7, 页码 1031-1043出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hlc.2020.12.018
关键词
Peripheral artery disease; Cardiac rehabilitation; Coronary artery disease; Secondary prevention; Cardiovascular rehabilitation
The majority of cardiac rehabilitation programs in Canada accept referrals for individuals with peripheral artery disease, but actual participation rates are low, with barriers including lack of referrals and program capacity constraints. Facilitators for participation include providing information on benefits of CRPs to referral sources and patients, PAD-specific education for staff, and PAD-toolkits for prescribing aerobic/resistance training.
Purpose To determine the proportion of cardiac rehabilitation programs (CRPs) in Canada that accept referrals for individuals with peripheral artery disease (PAD), eligibility criteria, and barriers/facilitators to inclusion. Methods CRPs across Canada were sent a web-based questionnaire. Results Of 180 questionnaires sent, 98 CRP managers representing 114 CRPs (62.6% of CRPs in Canada) responded. Of respondents, 81.6% accepted referrals for people with PAD; however 44.6% reported that <10 patients participated in the previous calendar year; two CRPs had no participants. Of CRPs accepting PAD, 23.7% accepted patients only with coexisting cardiac disease, 68.4% accepted post-lower limb amputees with prosthesis and 53.9% without prosthesis (non-ambulatory). Further, 32.2% did not provide formal/ informal PAD-specific education to patients and only 14.3% provided education to staff regarding PAD in the previous 3 years. Three (3) numerical pain scales were used to guide exercise intensity. Within these scales up to four pain thresholds were used. Most frequently cited barriers to participation included lack of referrals (61.6%), and programs being at capacity (59.3%). Frequently cited facilitators were providing information on benefits of CRPs to referral sources (88.3%) and patients (88.3%), providing PAD-specific education to staff (85.5%), and PAD-toolkits for prescribing aerobic/resistance training (81.5%, both). Conclusion Most CRPs accept individuals with PAD, however, few are referred. Inclusion of PAD with and without cardiac disease, collaboration between referral source and CRPs to improve the referral process, and PAD-specific education for staff and information/brochures on benefits of CRPs for patients and referral sources should improve participation and delivery of secondary prevention strategies.
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