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Heart, Lung and Circulation
Editorial| Volume 29, ISSUE 9, P1273-1277, September 2020

Cardiac Rehabilitation Quality in Australia: Proposed National Indicators for Field-Testing

Published:April 30, 2020DOI:https://doi.org/10.1016/j.hlc.2020.02.014
      Comprehensive exercise-based cardiac rehabilitation (CR) has well-established efficacy and effectiveness for improving patients' outcomes [
      • Anderson L.
      • Oldridge N.
      • Thompson D.R.
      • Zwisler A.D.
      • Rees K.
      • Martin N.
      • et al.
      Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis.
      ,
      • Van Halewijn G.
      • Deckers J.
      • Tay H.Y.
      • van Domburg R.
      • Kotseva K.
      • Wood D.
      Lessons from contemporary trials of cardiovascular prevention and rehabilitation: a systematic review and meta-analysis.
      ]. However, delivery of CR programs varies substantially [
      • Pesah E.
      • Supervia M.
      • Turk-Adawi K.
      • Grace S.L.
      A review of cardiac rehabilitation delivery around the world.
      ] and these beneficial results are only achieved by high performing programs that include most guideline-recommended components. CR programs that assess and address multiple risk factors (six or more) or oversee prescription and monitoring of cardioprotective medications reduce all-cause mortality (27% and 65% respectively), whereas programs that do not include such components have no effect on these outcomes [
      • Pesah E.
      • Supervia M.
      • Turk-Adawi K.
      • Grace S.L.
      A review of cardiac rehabilitation delivery around the world.
      ]. Moreover, CR programs that monitor, promote and achieve high levels of exercise adherence by participants reduce all-cause and cardiovascular mortality (19% and 28% respectively), in contrast to the lack of effect of CR programs that have suboptimal exercise participation [
      • Abell B.
      • Glasziou P.
      • Hoffman T.
      The contribution of individual exercise training components to clinical outcomes in randomized controlled trials of cardiac rehabilitation: A systematic review and meta-regression.
      ].
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