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Review
. 2017 Feb;92(2):234-242.
doi: 10.1016/j.mayocp.2016.10.014. Epub 2016 Nov 15.

Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative

Philip A Ades  1 , Steven J Keteyian  2 , Janet S Wright  3 , Larry F Hamm  4 , Karen Lui  5 , Kimberly Newlin  6 , Donald S Shepard  7 , Randal J Thomas  8
Affiliations
Review

Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative

Philip A Ades et al. Mayo Clin Proc. 2017 Feb.

Abstract

The primary aim of the Million Hearts initiative is to prevent 1 million cardiovascular events over 5 years. Concordant with the Million Hearts' focus on achieving more than 70% performance in the "ABCS" of aspirin for those at risk, blood pressure control, cholesterol management, and smoking cessation, we outline the cardiovascular events that would be prevented and a road map to achieve more than 70% participation in cardiac rehabilitation (CR)/secondary prevention programs by the year 2022. Cardiac rehabilitation is a class Ia recommendation of the American Heart Association and the American College of Cardiology after myocardial infarction or coronary revascularization, promotes the ABCS along with lifestyle counseling and exercise, and is associated with decreased total mortality, cardiac mortality, and rehospitalizations. However, current participation rates for CR in the United States generally range from only 20% to 30%. This road map focuses on interventions, such as electronic medical record-based prompts and staffing liaisons that increase referrals of appropriate patients to CR, increase enrollment of appropriate individuals into CR, and increase adherence to longer-term CR. We also calculate that increasing CR participation from 20% to 70% would save 25,000 lives and prevent 180,000 hospitalizations annually in the United States.

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Conflict of interest statement

Potential Competing Interests: Dr Keteyian reports personal fees from NimbleHeart, Inc, unrelated to the submitted work. Ms Lui reports that GRQ, LLC, represents the American Association of Cardiovascular and Pulmonary Rehabilitation regarding regulatory and legislative issues that affect cardiac rehabilitation.

Figures

FIGURE
FIGURE
Conceptual framework for increasing cardiac rehabilitation (CR) participation from 20% to 70%. EMR = electronic medical record.
See this image and copyright information in PMC

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