促进患者使用门诊心脏康复：一份联合国际委员会和加拿大心血管预防与康复协会的立场声明。
Promoting Patient Utilization of Outpatient Cardiac Rehabilitation: A JOINT INTERNATIONAL COUNCIL AND CANADIAN ASSOCIATION OF CARDIOVASCULAR PREVENTION AND REHABILITATION POSITION STATEMENT.
机构信息
School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada (Ms Santiago de Araújo Pio and Dr Grace); College of Nursing, University of South Florida, Tampa (Dr Beckie); The Australian eHealth Research Centre, CSIRO, Floreat, Australia (Dr Varnfield); Australian Cardiovascular Health and Rehabilitation Association (ACRA), New South Wales, Australia (Dr Varnfield); Faculty of Medicine, School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada (Dr Sarrafzadegan); Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran (Dr Sarrafzadegan); Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India (Dr Babu); Department of Physiotherapy, Kathmandu University, Dhulikhel Hospital, Dhulikhel, Nepal (Ms Baidya); University Centre Shrewsbury, Shrewsbury, England (Dr Buckley); Department of Physical Medicine & Rehabilitation, Fu Jen Catholic University Hospital and College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan (Dr Chen); Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan (Dr Chen); Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada (Dr Gagliardi); Institute of Sport and Exercise Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa (Dr Heine); Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam (Mr Khiong); Care Transitions and Population Health Management, New York University Langone Health Medical Center, New York City (Dr Mola); National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia (Dr Radi); Department of Physical Medicine and Rehabilitation, Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Madrid, Spain (Dr Supervia); Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota (Dr Supervia); Philippine Heart Association, Pasig City, Philippines (Dr Trani); Cardiology Department, Hospital Santa Maria, CHLN, Lisbon, Portugal (Dr Abreu); Medical School of University of Lisbon, Lisbon, Portugal (Dr Abreu); Public Education and Special Projects, Cardiac Health Foundation of Canada, Toronto, Ontario, Canada (Mr Sawdon); Patient Partner Program, University Health Network, Toronto, Canada (Mr Moffatt); and Toronto Rehabilitation Institute, KITE-University Health Network, University of Toronto, Canada (Dr Grace).
出版信息
J Cardiopulm Rehabil Prev. 2020 Mar;40(2):79-86. doi: 10.1097/HCR.0000000000000474.
PURPOSE
Cardiac rehabilitation (CR) is a recommendation in international clinical practice guidelines given its benefits; however, use is suboptimal. The purpose of this position statement was to translate evidence on interventions that increase CR enrollment and adherence into implementable recommendations.
METHODS
The writing panel was constituted by representatives of societies internationally concerned with preventive cardiology and included disciplines that would be implementing the recommendations. Patient partners served, as well as policy makers. The statement was developed in accordance with AGREE II, among other guideline checklists. Recommendations were based on our update of the Cochrane review on interventions to promote patients' utilization of CR. These were circulated to panel members, who were asked to rate each on a 7-point Likert scale in terms of scientific acceptability, actionability, and feasibility of assessment. A Web call was convened to achieve consensus and confirm strength of the recommendations (based on Grading of Recommendations Assessment, Development, and Evaluation [GRADE]). The draft underwent external review and public comment.
RESULTS
The 3 drafted recommendations were that to increase enrollment, health care providers, particularly nurses (strong), should promote CR to patients face-to-face (strong), and that to increase adherence, part of CR could be delivered remotely (weak). Ratings (mean ± SD) for the 3 recommendations were 5.95 ± 0.69, 5.33 ± 1.12, and 5.64 ± 1.08, respectively.
CONCLUSIONS
Interventions can significantly increase utilization of CR and hence should be widely applied. We call upon cardiac care institutions to implement these strategies to augment CR utilization and to ensure that CR programs are adequately resourced to serve enrolling patients and support them to complete programs.
目的
心脏康复（CR）在国际临床实践指南中被推荐，因为它具有益处；然而，其使用并不理想。本立场声明的目的是将增加 CR 参与度和坚持度的干预措施的证据转化为可实施的建议。
方法
写作小组成员由国际关注预防心脏病学的学会代表组成，包括将实施这些建议的学科。患者伙伴和政策制定者也参与其中。该声明是根据 AGREE II 以及其他指南清单制定的。建议是基于我们对促进患者参与 CR 的干预措施的 Cochrane 综述的更新。这些建议分发给小组成员，要求他们根据科学可接受性、可操作性和评估可行性，在 7 分制量表上对每一条进行评分。召开了网络电话会议，以达成共识并确认建议的强度（基于推荐评估、制定和评估 [GRADE]）。草案经过外部审查和公众意见。
结果
提出了 3 条建议，即增加参与度，医疗保健提供者，特别是护士（强烈），应面对面地向患者宣传 CR（强烈），增加坚持度，CR 的一部分可以远程提供（弱）。这 3 条建议的评分（平均值 ± 标准差）分别为 5.95 ± 0.69、5.33 ± 1.12 和 5.64 ± 1.08。
结论
干预措施可以显著增加 CR 的利用率，因此应广泛应用。我们呼吁心脏护理机构实施这些策略，以增加 CR 的利用率，并确保 CR 计划有足够的资源来为入组患者提供服务，并支持他们完成计划。
Zotero 插件