Qatar University (QU) has participated in a global study showing “gross cardiac rehabilitation insufficiency worldwide”.
Just one in 12 heart attack victims globally receive rehabilitation to prevent another event, according to the first-ever audit of cardiac rehabilitation around the world, undertaken by the International Council of Cardiovascular Prevention and Rehabilitation (ICCPR).
Over 18mn more spots are needed every year, according to a press statement issued by QU.
Senior author Professor Sherry Grace of York University and University Health Network, Canada, said: “Almost half the countries around the world have absolutely no rehab programmes and people will be dying unnecessarily without them.”
Two papers reporting on the global audit have been published in the journal EClinicalMedicine of the prestigious Lancet journal family, quantifying how much rehab capacity exists in relation to the need in every country of the world, and the quality of programmes in countries where it does exist.
The region of Africa is greatly in need of more programmes while India, China, and Russia each needs millions more rehabilitation spots to treat the average number of patients who develop heart disease each year currently.
“Unfortunately, that number is expected to grow,” the statement notes.
The two papers are a culmination of three years of effort among a global collaborative team of 60 investigators and other collaborators.
The research was led by Professor Sherry Grace of York University/Canada and three primary investigators: Dr Karam Turk-Adawi from Qatar University, Dr Francisco Lopez-Jimenez from the US’s Mayo Clinic, and Dr Marta Supervia from Gregorio Mara??n General University Hospital of Spain.
The papers report on the first-ever audit of cardiac rehab programmes globally, undertaken in response to calls by international organisations – including the World Health Organisation – for implementation of preventive strategies to reduce the burden of cardiovascular disease, the leading killer worldwide.
The protocol of this global survey was endorsed by international organisations, including the World Heart Federation.
“This is a call for governments and policy-makers to support cardiac rehab programmes,” said lead author Turk-Adawi from QU. “Every patient with heart disease has the right to have a place in a cardiac rehab programme.
“It is sad to see patients dying at young ages from this preventable disease, especially in developing countries, while they can benefit from the programme.”
Turk-Adawi reports the situation is the same in the Middle East, where only half the countries offer rehabilitation programmes and 2,079,283 more rehab spots are needed every year to treat new cases of heart disease.
“In Qatar, despite having a well-established programme with good quality and a plan for its expansion, there is only one spot for every 37 heart patients who need it. We need capacity to treat 6,811 more patients every year,” he adds.
Professor Asmaa al-Thani, dean of the College of Health Sciences at QU, expressed the university’s support for such research, which serves global health. “This is an important global study that underlines a gap in health services worldwide.
“Qatar University supports national and international efforts to mitigate the effects of major health issues like heart disease.”
The almost 6,000 programmes that did exist generally met the minimum recommended standards, offering an average of nine of the 11 core components, but this varied by region.
There was patchy delivery of interventions to stop smoking, manage stress and support return to work.
“Tobacco cessation is one of the most effective ways to reduce the risk of heart attacks and prolong survival, so all cardiac rehabilitation programmes should offer this service,” said Dr Supervia, lead author of the sister paper, from Gregorio Mara??n General University Hospital in Spain. “Likewise, programmes require more consistent provision of return-to-work support, such as negotiating modified work or part-time employment to help patients maintain a rewarding life and financial stability, while reducing the negative impact of cardiovascular disease on the economy.”
Grace of York University said advocacy is needed for more programmes that are reimbursed by public healthcare systems or private healthcare insurance.
She continued: “Increased capacity could also be achieved by delivering more unsupervised programmes, for example, by exploiting technology through home-based cardiac rehabilitation, which was only offered in 38 countries.
“Delivery in these settings is just as effective at reducing death in heart patients.”