Closer to the Heart: Why Proximity Matters for Improved Cardiac Rehab

October 2018

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Cardiac rehabilitation and secondary prevention (CRSP) programs are recommended for patients with cardiovascular disease, however participation in these programs is believed to be alarmingly low.

At the Canadian Cardiovascular Congress, where hundreds of cardiovascular specialists and allied healthcare professionals have gathered to network, learn and showcase the latest in research and innovations, The Beat caught up with one specialist who addressed the heart of this very issue.

“We know that cardiovascular rehabilitation and secondary prevention programs save lives and improve the quality of life for people with all forms of vascular disease,” said Dr. Joseph A. Ricci, Director of the Regional Cardiac Care Program at Scarborough and Rouge Hospital. “The issue is that access to rehabilitation is limited because patients have multiple barriers to attendance.” Ricci said CRSP programs are too often not offered close enough to home.

The problem we faced was to increase access to the services that would save patients’ lives, provide the service close to home by a professional workforce and ‘demedicalize’ it so patients are comfortable and stay in the program.

- Joseph Ricci, MD

Ricci is one of the principal authors of a new study into whether a re-imagined CRSP model might produce favourable outcomes in patients with cardiovascular disease. Specifically, the study’s objective was to determine the impact of a regional 6-month, once per week supervised exercise session CRSP model on mortality and re-hospitalization in comparison to a matched control group in a regional health care system.

Dr. Joseph Ricci discussed his research, titled Impact on Mortality After a Health Region in Ontario Implements an Integrated Cardiovascular Rehabilitation and Secondary Prevention System, in a short video recorded at CCC in Toronto.

The Central East Local Health Integration Network designed and implemented a CRSP service delivery system that was regionally coordinated, centrally managed, and community-based. The most notable changes included: referral criterion, directly contacting all eligible patients for referral, and service delivery at 14 different sites, accessible to the majority of patients within a 30-minute drive.

The study concluded that patients who completed the CRSP program closer to home experienced lower mortality and re-hospitalization rates when compared to patients not referred.

“The problem we faced was to increase access to the services that would save patients’ lives, provide the service close to home by a professional workforce and ‘demedicalize’ it so patients are comfortable and stay in the program,” said Ricci following his poster presentation at CCC.

“We believe if we can do that – which  we did – then participation rates should be in the range of 70 to 80 per cent, mortality should drop, hospitalization should drop, and the healthcare system should have healthier patients that cost much less money for the system as a whole.”

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