DefinePK

Research Objective

To review the concept of cardiac rehabilitation, its benefits, recent achievements, and the challenges that remain in its implementation, particularly in developing countries.

Methodology

This is a short communication and review article. It synthesizes existing evidence and discusses the current state of cardiac rehabilitation programs, drawing on data and observations from the Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC & NIHD) in Pakistan.

Methodology Flowchart

                        graph TD;
    A["Identify need for Cardiac Rehabilitation review"] --> B["Gather existing literature and data"];
    B --> C["Analyze global CR status and benefits"];
    C --> D["Identify challenges in CR implementation"];
    D --> E["Examine achievements and services at AFIC & NIHD"];
    E --> F["Discuss novel delivery models and COVID-19 impact"];
    F --> G["Formulate conclusions and recommendations"];
    G --> H["Structure the article: Title, Objective, Methodology, Findings, Discussion, Conclusion, Keywords, References"];                    

Discussion

The article highlights the global burden of cardiovascular disease (CVD) and the critical role of CR in managing risk factors and improving patient outcomes. It discusses the multidisciplinary team required for effective CR and the importance of tailored plans. Challenges in Pakistan, such as expensive treatment options and limited access to specialized care, necessitate a focus on prevention. The impact of the COVID-19 pandemic on traditional group-based CR sessions is also noted, leading to a shift towards individual patient visits and outdoor clinics.

Key Findings

Cardiac rehabilitation (CR) is a complex intervention with proven clinical and cost-effectiveness, yet its uptake is suboptimal globally due to various factors including physician reluctance, patient psychological well-being, geographical access, and dislike of group sessions. Developing countries face additional challenges with limited resources and access to tertiary care. AFIC & NIHD provides a multidisciplinary approach to CR, offering services like psychological counseling, physiotherapy, and dietary plans. Novel delivery models, including digital platforms, are emerging to improve accessibility.

Conclusion

Cardiac rehabilitation is a vital component of cardiovascular care, but significant challenges in implementation and uptake persist, especially in resource-limited settings. A concentrated effort on prevention, alongside innovative delivery models and improved access, is crucial to address the growing burden of CVD.

Fact Check

- Global participation rate in CR programs in the US is estimated to be 20-30%.
- Worldwide, only 38.8% of countries have CR programs.
- In Pakistan, approximately 944 patients received psychological counseling, 1274 received physiotherapy, and 2556 received dietary counseling from April to September 2021 at AFIC & NIHD.

Mind Map