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Availability and nature of cardiac rehabilitation by province in Iran: A 2018 update of ICCPR's global audit
Masoumeh Sadeghi1, Karam Turk-Adawi2, Marta Supervia3, Mohammad Rafati Fard1, Fereydoun Noohi4, Hamidreza Roohafza1, Nizal Sarrafzadegan5, Sherry L Grace6
1 Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Public Health, QU-Health, Qatar University, Doha, Qatar
3 Medicina Física y Rehabilitación, Gregorio Marañón Health Research Institute, Gregorio Marañón General University Hospital, Madrid, Spain; Department of Cardiovascular Medicine, Division of Preventive Cardiology, Mayo Clinic, Rochester, Minnesota, USA
4 Rajaie Cardiovascular, Medical and Research Center, Iranian Network of Cardiovascular Research, Tehran, Iran
5 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; School of Population and Public Health, University of British Columbia, Vancouver, Canada
6 Faculty of Health, York University; KITE-Toronto Rehabilitation Institute and Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
Correspondence Address:
Prof. Sherry L Grace
York University, 4700 Keele Street, Toronto, ON M3J1P3
Canada
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jrms.jrms_68_21
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Background: Cardiac rehabilitation (CR) is scantly available in Iran, although it is the cost-benefit strategy in cardiac patients, It has not been established how CR is delivered within Iran. This study aimed to determine: (a) availability, density and unmet need for CR, and (b) nature of CR services in Iran by province. Materials and Methods: In this cross-sectional sub-study of the global CR audit, program availability was determined through cardiovascular networks. An online survey was then disseminated to these programs in June 2016–2017 which assessed capacity and characteristics; a paper-based survey was disseminated in 2018 to nonresponding and any new programs. CR density and need was computed based on annual incidence of acute myocardial infarction (AMI) in each province. Results: Of the 31 provinces, 12 (38.7%) had CR services. There were 30 programs nationally, all in capital cities; of these, programs in 9 (75.0%) provinces, specifically 22 (73.3%) programs, participated. The national CR density is 1 spot per 7 incident AMI patients/year. Unmet need is greatest in Khuzestan, Tehran and west Azerbaijan, with 44,816 more spots needed/year. Most programs assessed cardiovascular risk factors, and offered comprehensive services, delivered by a multi-disciplinary team, comprised chiefly of nurses, dietitians and cardiologists. Median dose is 14 sessions/program in supervised programs. A third of programs offered home-based services. Conclusion: Where programs do exist in IRAN, they are generally delivered in accordance with guidelines. Therefore, we must increase capacity in CR services in all provinces to improve secondary prevention services.
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