Nature, availability, and utilization of women-focused cardiac rehabilitation: a systematic review

Taslima Mamataz; Gabriela L M Ghisi; Maureen Pakosh; Sherry L Grace

doi:10.1186/s12872-021-02267-0

Nature, availability, and utilization of women-focused cardiac rehabilitation: a systematic review

BMC Cardiovasc Disord. 2021 Sep 23;21(1):459. doi: 10.1186/s12872-021-02267-0.

Authors

Taslima Mamataz^{1

2}, Gabriela L M Ghisi², Maureen Pakosh³, Sherry L Grace^{4

5}

Affiliations

¹ Faculty of Health, York University, Bethune 368, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
² KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
³ Library & Information Services, Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
⁴ Faculty of Health, York University, Bethune 368, 4700 Keele Street, Toronto, ON, M3J 1P3, Canada. sgrace@yorku.ca.
⁵ Peter Munk Cardiac Centre, KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, ON, Canada. sgrace@yorku.ca.

Abstract

Background: Women do not participate in cardiac rehabilitation (CR) to the same degree as men; women-focused CR may address this. This systematic review investigated the: (1) nature, (2) availability, as well as (3a) utilization of, and (b) satisfaction with women-focused CR.

Methods: Medline, Pubmed, Embase, PsycINFO, CINAHL, Web of Science, Scopus and Emcare were searched for articles from inception to May 2020. Primary studies of any design were included. Adult females with any cardiac diseases, participating in women-focused CR (i.e., program or sessions included ≥ 50% females, or was 1-1 and tailored to women's needs) were considered. Two authors rated citations for inclusion. One extracted data, including study quality rated as per the Mixed-Methods Assessment Tool (MMAT), which was checked independently by a second author. Results were analyzed in accordance with the Synthesis Without Meta-analysis (SWiM) reporting guideline.

Results: 3498 unique citations were identified, with 28 studies (53 papers) included (3697 women; ≥ 10 countries). Globally, women-focused CR is offered by 40.9% of countries that have CR, with 32.1% of programs in those countries offering it. Thirteen (46.4%) studies offered women-focused sessions (vs. full program), 17 (60.7%) were women-only, and 11 (39.3%) had gender-tailoring. Five (17.9%) programs offered alternate forms of exercise, and 17 (60.7%) focused on psychosocial aspects. With regard to utilization, women-focused CR cannot be offered as frequently, so could be less accessible. Adherence may be greater with gender-tailored CR, and completion effects are not known. Satisfaction was assessed in 1 trial, and results were equivocal.

Conclusions: Women-focused CR involves tailoring of content, mode and/or sex composition. Availability is limited. Effects on utilization require further study.

Keywords: Access; Adherence; Cardiac rehabilitation; Health services delivery; Healthcare utilization; Heart diseases; Satisfaction; Secondary prevention; Systematic review; Women.

Publication types

Systematic Review

MeSH terms

Aged
Cardiac Rehabilitation*
Delivery of Health Care*
Female
Health Services Accessibility*
Health Status Disparities
Healthcare Disparities*
Heart Diseases / diagnosis
Heart Diseases / epidemiology
Heart Diseases / physiopathology
Heart Diseases / rehabilitation*
Humans
Middle Aged
Patient Satisfaction
Patient-Centered Care*
Recovery of Function
Risk Assessment
Risk Factors
Sex Factors
Treatment Outcome
Women's Health Services*