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February 14, 2020
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Q&A: Cardiac Rehabilitation Week underscores barriers to care, need for adherence

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Ana Mola

The American Association of Cardiovascular and Pulmonary Rehabilitation’s annual Cardiac Rehabilitation Week began Sunday with the new theme, “New Start, Better Heart,” and the aim of increasing awareness of its importance in CV health.

To discuss the importance of cardiac rehabilitation initiation, adherence and barriers to care, Healio corresponded with Ana Mola, PhD, RN, ANP-C, MAACVPR, clinical professor of rehabilitation medicine at NYU School of Medicine and president of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) board of directors.

 

What is the aim of Cardiac Rehabilitation Week?

Cardiac Rehabilitation Week happens annually the week of Valentine’s Day to draw attention to the role cardiac rehabilitation plays in reducing the potentially devastating effects of heart disease. Every year, cardiac rehab professionals around the country use this week to recognize team members for their contributions and share valuable educational resources to advance patient care. This year’s theme is “New Start, Better Heart.”

 

Why is this important?

Recent scientific studies have shown that people who complete 36 1-hour cardiac rehabilitation sessions can increase their life expectancy by up to 5 years. But only 1 in 4 eligible Medicare beneficiaries completed cardiac rehab in 2017; of those, less than one-third completed the whole session (Ritchey MD, et al. Circ Cardiovasc Qual Outcomes. 2020;doi:10.1161/CIRCOUTCOMES.119.005902). By drawing attention to the benefits of cardiac rehab and sharing innovative approaches, we can increase the adherence and completion of prescribed cardiac rehab.

 

What notable advances/research in cardiac rehabilitation have been done in the past year?

Last year, the AACVPR Innovative Delivery Model Collective brought together thought leaders, subject matter experts and industry partners with a vested interest in innovative approaches to cardiac rehabilitation delivery. AACVPR is advancing the evidence-based research around home-based cardiac rehabilitation, or HBCR, outcomes and enhancing literature to clearly define a best-practice model. Our member programs are also getting creative in reducing the barriers to cardiac rehab treatment using two models of incentives — financial incentives, specifically in low-income communities, and awards and prizes for milestones. Many have also implemented patient ambassador programs and group formats to encourage completion.

 

What shortcomings still need to be addressed/researched?

In recent years, there has been a significant increase in interest in HBCR delivery. However, there remain unanswered questions and barriers to adoption. In short, more research, robust clinical trials and clear data on how to identify eligible patients is needed to define HBCR and provide individualized treatment plan requirements and outcomes measures. Likewise, we need more research on HF with preserved ejection fraction and studies on smoking cessation and enrollment and adherences; most existing studies are specific to tobacco and do not address the growing trend of e-cigarette usage.

 

Anything else you would like to add?

The AACVPR is a multidisciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation. Our members include CV and pulmonary physicians, nurses, exercise physiologists, physical therapists, behavioral scientists, respiratory therapists, dietitians and nutritionists. – by Scott Buzby

Disclosure: Mola reports she is a technical content expert for ABY Associates and the Agency for Healthcare Research and Quality TAKEheart initiative.