Katie Palmer1, Kelly-Ann Bowles2, Rebecca Lane3, Julia Morphet4. 1. Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Vic, Australia; Monash Health, Melbourne, Vic, Australia. Electronic address: Katie.palmer1@monash.edu. 2. Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Vic, Australia. 3. Australian Catholic University, Melbourne, Vic, Australia. 4. School of Nursing and Midwifery, Monash University, Melbourne, Vic, Australia.
Abstract
BACKGROUND: While exercise has been shown to improve quality of life and physical function and reduce hospital admission rates in people with chronic heart failure (CHF), engagement is poor in condition specific rehabilitation programs. This project aims to identify barriers to engagement in rehabilitation, strategies to address these, and comprehensively detail CHF rehabilitation practise in Australia. METHODS: An online survey was emailed to all cardiac and chronic heart failure rehabilitation programs in Australia utilising a publicly available database. RESULTS: The survey was completed by 165 respondents: Australian Capital Territory (ACT) = 4, New South Wales (NSW) = 49, Northern Territory (NT) = 2, Queensland (Qld) = 23, South Australia (SA) = 12, Tasmania (Tas) = 2, Victoria (Vic) = 37, Western Australia (WA) = 12, including metropolitan (37%), regional (47%) and remote (9%) locations. Common barriers were themed into four areas: poor condition-specific health literacy, lack of medical professional support, interrupted health care systems, and personal and external deterrents. Strategies to improve engagement and attendance focussed mostly on the patient, with few strategies aimed at improving patient and health professional knowledge and referral processes. Programs generally appeared to follow current Australian Heart Foundation recommendations for CHF rehabilitation. CONCLUSIONS: This survey identifies common barriers that need to be addressed to improve engagement and attendance levels in CHF rehabilitation programs. While patient barriers are already being addressed, strategic planning needs to occur to address poor health literacy including for medical and health professionals, improved flow through the health care system and improving the flexibility of program delivery. Adaptation of home-based and tele-rehabilitation can help with this, while education and advertisement to patients and potential referrers needs to start early in the disease journey.
BACKGROUND: While exercise has been shown to improve quality of life and physical function and reduce hospital admission rates in people with chronic heart failure (CHF), engagement is poor in condition specific rehabilitation programs. This project aims to identify barriers to engagement in rehabilitation, strategies to address these, and comprehensively detail CHF rehabilitation practise in Australia. METHODS: An online survey was emailed to all cardiac and chronic heart failure rehabilitation programs in Australia utilising a publicly available database. RESULTS: The survey was completed by 165 respondents: Australian Capital Territory (ACT) = 4, New South Wales (NSW) = 49, Northern Territory (NT) = 2, Queensland (Qld) = 23, South Australia (SA) = 12, Tasmania (Tas) = 2, Victoria (Vic) = 37, Western Australia (WA) = 12, including metropolitan (37%), regional (47%) and remote (9%) locations. Common barriers were themed into four areas: poor condition-specific health literacy, lack of medical professional support, interrupted health care systems, and personal and external deterrents. Strategies to improve engagement and attendance focussed mostly on the patient, with few strategies aimed at improving patient and health professional knowledge and referral processes. Programs generally appeared to follow current Australian Heart Foundation recommendations for CHF rehabilitation. CONCLUSIONS: This survey identifies common barriers that need to be addressed to improve engagement and attendance levels in CHF rehabilitation programs. While patient barriers are already being addressed, strategic planning needs to occur to address poor health literacy including for medical and health professionals, improved flow through the health care system and improving the flexibility of program delivery. Adaptation of home-based and tele-rehabilitation can help with this, while education and advertisement to patients and potential referrers needs to start early in the disease journey.
Authors: Paulina Daw; Alexander Harrison; Patrick J Doherty; Jet J C S Veldhuijzen van Zanten; Hasnain M Dalal; Rod S Taylor; Samantha B van Beurden; Sinéad T J McDonagh; Colin J Greaves Journal: BMC Cardiovasc Disord Date: 2022-06-16 Impact factor: 2.174
Authors: Paulina Daw; Thomas M Withers; Jet J C S Veldhuijzen van Zanten; Alexander Harrison; Colin J Greaves Journal: BMC Health Serv Res Date: 2021-11-24 Impact factor: 2.908