Evidence map›Paper›PMID 31477103›Full record

ArticleBMC health services research2019

Barriers to cardiac rehabilitation delivery in a low-resource setting from the perspective of healthcare administrators, rehabilitation providers, and cardiac patients.

Thaianne Cavalcante Sérvio, Raquel Rodrigues Britto, Gabriela Lima de Melo Ghisi, Lilian Pinto da Silva, Luciana Duarte Novais Silva, Márcia Maria Oliveira Lima, Danielle Aparecida Gomes Pereira, Sherry L Grace

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 1 pooled it
6.4field-weighted citation impact, top 3% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 1 synthesis or guideline pooled it, 83 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Thaianne Cavalcante SérvioRehabilitation Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Raquel Rodrigues BrittoRehabilitation Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. r3britto@gmail.com.ORCID http://orcid.org/0000-0002-9533-3654
Gabriela Lima de Melo GhisiCardiovascular Prevention and Rehabilitation Program, University Health Network, University of Toronto, Toronto, Canada.
Lilian Pinto da SilvaCollege of Physical Therapy, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
Luciana Duarte Novais SilvaDepartment of Applied Physical Therapy, Universidade Federal do Triângulo Mineiro, Uberaba, Brazil.
Márcia Maria Oliveira LimaDepartment of Physical Therapy, Universidade Federal do Vale do Jequitinhonha e Mucuri, Diamantina, Brazil.
Danielle Aparecida Gomes PereiraRehabilitation Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Sherry L GraceCardiovascular Prevention and Rehabilitation Program, University Health Network, University of Toronto, Toronto, Canada.
Universidade Federal de Minas Gerais · BRUniversity Health Network · CAUniversidade Federal de Juiz de Fora · BRUniversidade Federal dos Vales do Jequitinhonha e Mucuri · BRUniversidade Federal do Triângulo Mineiro · BR

Funding

Conselho Nacional de Desenvolvimento Científico e Tecnológico #305786/2014-8Coordenação de Aperfeiçoamento de Pessoal de Nível Superior Finance Code 001Fundação de Amparo à Pesquisa do Estado de Minas Gerais #APQ-03512-13Fundação de Amparo à Pesquisa do Estado de Minas Gerais #PPM-00869-15
6 · The paper itself

Abstract

backgroundDespite clinical practice guideline recommendations that cardiovascular disease patients participate, cardiac rehabilitation (CR) programs are highly unavailable and underutilized. This is particularly true in low-resource settings, where the epidemic is at its' worst. The reasons are complex, and include health system, program and patient-level barriers. This is the first study to assess barriers at all these levels concurrently, and to do so in a low-resource setting.

methodsIn this cross-sectional study, data from three cohorts (healthcare administrators, CR coordinators and patients) were triangulated. Healthcare administrators from all institutions offering cardiac services, and providers from all CR programs in public and private institutions of Minas Gerais state, Brazil were invited to complete a questionnaire. Patients from a random subsample of 12 outpatient cardiac clinics and 11 CR programs in these institutions completed the CR Barriers Scale.

resultsThirty-two (35.2%) healthcare administrators, 16 (28.6%) CR providers and 805 cardiac patients (305 [37.9%] attending CR) consented to participate. Administrators recognized the importance of CR, but also the lack of resources to deliver it; CR providers noted referral is lacking. Patients who were not enrolled in CR reported significantly greater barriers related to comorbidities/functional status, perceived need, personal/family issues and access than enrollees, and enrollees reported travel/work conflicts as greater barriers than non-enrollees (all p < 0.01).

conclusionsThe inter-relationship among barriers at each level is evident; without resources to offer more programs, there are no programs to which physicians can refer (and hence inform and encourage patients to attend), and patients will continue to have barriers related to distance, cost and transport. Advocacy for services is needed.

Indexed as

Cardiac RehabilitationDeveloping CountriesHealth Services AccessibilityAgedBrazilCardiovascular DiseasesCross-Sectional StudiesFemaleHealth ResourcesHospital AdministratorsHumansMaleMiddle AgedReferral and ConsultationSurveys and QuestionnairesAttitude of health personnelCardiac care facilitiesCardiac rehabilitationHealth care services

Identifiers

PMID31477103
PMCPMC6719378
OpenAlexW2971401322

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.