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Nature of cardiac rehabilitation services in Portugal: comparative results from the global survey of programs
Session:
Posters 3 - Écran 4 - Reabilitação Cardíaca
Speaker:
Pedro Morais
Congress:
CPC 2019
Topic:
J. Preventive Cardiology
Theme:
29. Rehabilitation and Sports Cardiology
Subtheme:
29.2 Cardiovascular Rehabilitation
Session Type:
Posters
FP Number:
---
Authors:
Pedro Morais; M. Supervia; K. Turk-Adawi; J. Ruivo; F. Lopez-Jimenez; A. Abreu; S. Grace
Abstract
<p><strong>Aims</strong></p> <p>Evaluate the nature of cardiac rehabilitation (CR) services in Portugal comparing it to centers in 40 countries.</p> <p><strong>Methods and Results</strong></p> <p>A worldwide survey of CR programs was conducted online from February 2016 to July 2017. National cardiac associations and local champions facilitated programme identification. The main items evaluated were setting, management, referall, components, costs, accepted indications and session profile. 21 portuguese centers participated. Results from portuguese surveys were compared with 484 centers from 40 countries (European, Russia, Israel, Turkey, Kazakhstan and Georgia).</p> <p>CR started later in Portugal when compared with the abovementioned centers, with median year of initiation in 2008 against 2002 (older center starting in 1988 against 1950). Most portuguese centers operate in urban/suburban areas, one in rural area and none in Rehabilitation/Residential hospitals (vs 16.1% of all centers). Both in Portugal and in the overall, programs belong most frequently to Cardiology department and are led by a cardiologist, followed by Physical Medicine and Rehabilitation department, with the second most frequent leadership being a physiatrist in 16.7% of portuguese centers and a nurse in 16.2% overall.</p> <p>Portuguese programs have considerably less self-referred patients (11.1 vs 39.7% of all centers). Other less frequent referral pathways in the portuguese centers are other health professionals (27.8 vs 43.1%) and community health care workers (5.6 vs 26.6%).</p> <p>Patients in portuguese centers initiate CR programs later, with an average time for programme enrollment after discharge of 4.9 weeks (vs 3.6 weeks overall).</p> <p>Portuguese centers tend to have more complete programs, some items are significantly more prevalent (stress test, follow-up after program cessation, sleep apnea screening, education sessions) and some are less frequent (individual nurse consultation, vocational counseling/support for return to work).</p> <p>The perception of cost (scale of 1 to 5) averages 2.69 in portuguese centers (vs 2.73 overall). The most costing feature is blood collection and lipid testing (3.33) in portuguese centers vs fontline personnel (3.43) in the overall. The least costing feature was space (2.53) in portuguese centers vs education materials (2.18) in the overall.</p> <p>A similar proportion of portuguese centers accept non-cardiac chronic diseases as indication for programs when compared with the overall. Portuguese programs enroll less stable angina (64.7 vs 74.1%), heart faillure (64.7 vs 84.0%), heart transplant (23.5 vs 57.4%), device patients (64.7 vs 81.9%), congenital cardiopathy (23.5 vs 52.5%) and cardiomyopathy (41.2 vs 71.4%).</p> <p><strong>Conclusion­</strong></p> <p>Portuguese CR centers are recent, do not differ significantly from standard practice in Europe and nearby reagions, tend to have complete programs but still lack on referral pathways and different indications enrollment.</p>
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