Shobhit Ahden1, Vivian Ngo1, Jordan Hoskin1, Vanna Mach1, Selvia Magharious1, Amandeep Tambar1, Dina Brooks2, Andrée-Anne Hébert3, Susan Marzolini4. 1. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada. 2. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; McMaster University, Hamilton, ON, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. 3. Programme de Prévention Secondaire et Réadaptation Cardiovasculaire (PREV), Centre Intégré de Santé et Services Sociaux (CISSS) de Chaudière-Appalaches, Lévis, Québec, Canada. 4. Department of Physical Therapy, University of Toronto, Toronto, ON, Canada; KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Toronto, ON, Canada. Electronic address: Susan.marzolini@uhn.ca.
Abstract
PURPOSE: To determine the proportion of cardiac rehabilitation programs (CRPs) in Canada that accept referrals for individuals with peripheral artery disease (PAD), eligibility criteria, and barriers/facilitators to inclusion. METHODS: CRPs across Canada were sent a web-based questionnaire. RESULTS: Of 180 questionnaires sent, 98 CRP managers representing 114 CRPs (62.6% of CRPs in Canada) responded. Of respondents, 81.6% accepted referrals for people with PAD; however 44.6% reported that ≤10 patients participated in the previous calendar year; two CRPs had no participants. Of CRPs accepting PAD, 23.7% accepted patients only with coexisting cardiac disease, 68.4% accepted post-lower limb amputees with prosthesis and 53.9% without prosthesis (non-ambulatory). Further, 32.2% did not provide formal/informal PAD-specific education to patients and only 14.3% provided education to staff regarding PAD in the previous 3 years. Three (3) numerical pain scales were used to guide exercise intensity. Within these scales up to four pain thresholds were used. Most frequently cited barriers to participation included lack of referrals (61.6%), and programs being at capacity (59.3%). Frequently cited facilitators were providing information on benefits of CRPs to referral sources (88.3%) and patients (88.3%), providing PAD-specific education to staff (85.5%), and PAD-toolkits for prescribing aerobic/resistance training (81.5%, both). CONCLUSION: Most CRPs accept individuals with PAD, however, few are referred. Inclusion of PAD with and without cardiac disease, collaboration between referral source and CRPs to improve the referral process, and PAD-specific education for staff and information/brochures on benefits of CRPs for patients and referral sources should improve participation and delivery of secondary prevention strategies.
PURPOSE: To determine the proportion of cardiac rehabilitation programs (CRPs) in Canada that accept referrals for individuals with peripheral artery disease (PAD), eligibility criteria, and barriers/facilitators to inclusion. METHODS: CRPs across Canada were sent a web-based questionnaire. RESULTS: Of 180 questionnaires sent, 98 CRP managers representing 114 CRPs (62.6% of CRPs in Canada) responded. Of respondents, 81.6% accepted referrals for people with PAD; however 44.6% reported that ≤10 patients participated in the previous calendar year; two CRPs had no participants. Of CRPs accepting PAD, 23.7% accepted patients only with coexisting cardiac disease, 68.4% accepted post-lower limb amputees with prosthesis and 53.9% without prosthesis (non-ambulatory). Further, 32.2% did not provide formal/informal PAD-specific education to patients and only 14.3% provided education to staff regarding PAD in the previous 3 years. Three (3) numerical pain scales were used to guide exercise intensity. Within these scales up to four pain thresholds were used. Most frequently cited barriers to participation included lack of referrals (61.6%), and programs being at capacity (59.3%). Frequently cited facilitators were providing information on benefits of CRPs to referral sources (88.3%) and patients (88.3%), providing PAD-specific education to staff (85.5%), and PAD-toolkits for prescribing aerobic/resistance training (81.5%, both). CONCLUSION: Most CRPs accept individuals with PAD, however, few are referred. Inclusion of PAD with and without cardiac disease, collaboration between referral source and CRPs to improve the referral process, and PAD-specific education for staff and information/brochures on benefits of CRPs for patients and referral sources should improve participation and delivery of secondary prevention strategies.
Authors: James E Peterman; Ross Arena; Jonathan Myers; Susan Marzolini; Philip A Ades; Patrick D Savage; Carl J Lavie; Leonard A Kaminsky Journal: J Am Heart Assoc Date: 2021-11-08 Impact factor: 5.501
Authors: Mark A Faghy; Ross Arena; Abraham Samuel Babu; Jeffrey W Christle; Susan Marzolini; Dejana Popovic; Amber Vermeesch; Nicolaas P Pronk; Lee Stoner; Andy Smith Journal: Prog Cardiovasc Dis Date: 2022-07-13 Impact factor: 11.278