Availability and characteristics of cardiac rehabilitation programs in one Brazilian state: a cross-sectional study

Abstract

Background: Cardiac rehabilitation (CR) is a recommended model of care for cardiovascular diseases; however, is not widely available and is underutilized, especially in low- and middle-income countries.

Objectives: To identify the CR programs available in one Brazilian state (Minas Gerais; MG) and describe their characteristics by funding type.

Methods: In this multi-center descriptive study, CR programs were identified in four MG regions and 41 CR coordinators were sent a survey to report the characteristics of their programs, including CR components described in guidelines and barriers to patients' participation. Descriptive and comparative analysis between public and private programs were carried out.

Results: Forty-one CR programs were identified, only 21.9% public. Nineteen completed the survey. The majority of CR programs offered initial assessment and physical training. Components of comprehensive CR programs that were rarely offered included treatment of tobacco dependence, psychological support and lipid control. Physical therapists were present in all CR programs. The six-minute walk test was used in most programs to assess functional capacity. Programs were located intra-hospital only in public hospitals. Phase 2 (initial outpatient) and phase 4 (maintenance) were offered significantly more in private programs when compared to public ones. The main barrier for CR participation was the lack of referral.

Conclusions: The availability of CR programs in MG state is low, especially public programs. Most programs do not offer all core components of CR.

Keywords: Cardiac rehabilitation; Cardiovascular diseases; Health services accessibility.