Purpose of Review

Cardiac rehabilitation (CR) is grossly under-utilized. This review summarizes current knowledge about degree of CR utilization, reasons for under-utilization, and strategies to increase use.

Recent Findings

ICCPR’s global CR audit quantified for the first time the number of additional CR spots needed per year to treat indicated patients, so there are programs they may use. The first randomized trial of automatic/systematic CR referral has shown it results in significantly greater patient completion. Moreover, the recent update of the Cochrane review on interventions to increase use has provided unequivocal evidence on the significant impact of clinician CR encouragement at the bedside; a course is now available to train clinicians.

Summary

The USA is leading the way in implementing automatic referral with inpatient-clinician CR discussions. Suggestions to triage patients based on risk to less resource-intensive, unsupervised program models could simultaneously expand capacity and support patient adherence.

中文翻译：

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心脏康复：全球未充分利用

审查目的

心脏康复 (CR) 的利用严重不足。本综述总结了当前关于 CR 使用程度、未充分利用的原因以及增加使用策略的知识。

最近的发现

ICCPR 的全球 CR 审计首次量化了每年治疗指定患者所需的额外 CR 点数量，因此他们可能会使用一些程序。第一项自动/系统 CR 转诊的随机试验表明，它显着提高了患者的完成率。此外，最近更新的关于增加使用干预措施的 Cochrane 评价为临床医生在床边鼓励 CR 的显着影响提供了明确的证据；现在提供培训临床医生的课程。

总结

美国正在通过住院-临床医生 CR 讨论在实施自动转诊方面处于领先地位。根据资源密集度较低、无人监督的项目模型的风险对患者进行分类的建议可以同时扩大容量并支持患者依从性。