Evidence map›Paper›PMID 27181874›Full record

GuidelineHeart (British Cardiac Society)2016

Cardiac rehabilitation delivery model for low-resource settings.

Sherry L Grace, Karam I Turk-Adawi, Aashish Contractor, Alison Atrey, Norm Campbell, Wayne Derman, Gabriela L Melo Ghisi, Neil Oldridge, Bidyut K Sarkar, Tee Joo Yeo and 5 more

Registry-linked trialAbstract readPractice GuidelineReview
PubMed Full text at PMC Publisher
In one paragraph

Guideline in Heart (British Cardiac Society), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04505150 (Lowering Blood Pressure by Changing Lifestyle Through a Motivational Education Program), which is not on this map. Cited by 69 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
69citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04505150 naunknown statusnot on this mapstarted 2020, after this paper: background citation

Lowering Blood Pressure by Changing Lifestyle Through a Motivational Education Program: a Cluster RCT Study Protocol

TypeinterventionalSponsorOrganisation for Rural Community Development, BangladeshRan2020 to 2022Enrolled300ConditionsHigh Blood PressureArmsLifestyle changes, e.g., take part in regular exercise, quitting smoking, and reduce salt consumption
3 · Its place in the literature

Who cites it

69 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Effects of cardiac rehabilitation treatment modalities in Sub-Saharan Africa: A systematic review.Malawi medical journal : the journal of Medical Association of Malawi · 2021
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9 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Sherry L GraceFaculty of Health, School of Kinesiology and Health Science, York University, and Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
Karam I Turk-AdawiSchool of Health Policy and Management, York University, Toronto, Ontario, Canada.
Aashish ContractorRehabilitation and Sports Medicine, Sir H. N. Reliance Foundation Hospital, Mumbai, India.
Alison AtreyImperial College, Cambridgeshire, UK.
Norm CampbellLibin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada.
Wayne DermanInstitute of Sport and Exercise Medicine (SEM), Faculty of Medicine and Health Sciences, University of Stellenbosch, Cape Town, South Africa.
Gabriela L Melo GhisiDepartment of Exercise Sciences, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada.
Neil OldridgeCollege of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA.
Bidyut K SarkarResearch Division, Public Health Foundation of India, ISID Campus, New Delhi, India.
Tee Joo YeoDepartment of Cardiology, National University Heart Centre Singapore, Singapore.
Francisco Lopez-JimenezCardiovascular Health Clinic and Cardiometabolic Program, Mayo Clinic, Rochester, Minnesota, USA.
Shanthi MendisChronic Diseases Prevention and Management, NCD, WHO, Geneva, Switzerland.
Paul OhUHN Cardiovascular Prevention and Rehabilitation Program, Toronto, Ontario, Canada.
Dayi HuHeart Center, People Hospital of Peking University, Beijing, China.
Nizal SarrafzadeganIsfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.

Funding

World Health Organization 001
6 · The paper itself

Abstract

objectiveCardiovascular disease is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be cost-effective and efficacious in high-income countries. CR could represent an important approach to mitigate the epidemic of cardiovascular disease in lower-resource settings. The purpose of this consensus statement was to review low-cost approaches to delivering the core components of CR, to propose a testable model of CR which could feasibly be delivered in middle-income countries.

methodsA literature review regarding delivery of each core CR component, namely: (1) lifestyle risk factor management (ie, physical activity, diet, tobacco and mental health), (2) medical risk factor management (eg, lipid control, blood pressure control), (3) education for self-management and (4) return to work, in low-resource settings was undertaken. Recommendations were developed based on identified articles, using a modified GRADE approach where evidence in a low-resource setting was available, or consensus where evidence was not.

resultsAvailable data on cost of CR delivery in low-resource settings suggests it is not feasible to deliver CR in low-resource settings as is delivered in high-resource ones. Strategies which can be implemented to deliver all of the core CR components in low-resource settings were summarised in practice recommendations, and approaches to patient assessment proffered. It is suggested that CR be adapted by delivery by non-physician healthcare workers, in non-clinical settings.

conclusionsAdvocacy to achieve political commitment for broad delivery of adapted CR services in low-resource settings is needed.

Indexed as

Health Care CostsActivities of Daily LivingCardiac RehabilitationCardiovascular DiseasesConsensusCost-Benefit AnalysisDelivery of Health CareExercise TherapyHealth ResourcesHumansModels, OrganizationalPatient Education as TopicReturn to WorkRisk Reduction BehaviorSelf Care

Identifiers

PMID27181874
PMCPMC5013107

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.