Key result
Cardiac rehabilitation services cover only ~39% of Iranian provinces, highlighting massive unmet need.
Why the study?
Cardiac rehabilitation is scantly available in Iran despite being a cost-benefit strategy, and how it is delivered within the country has not been established.
Cross-Sectional (n=22)
Yes
There is a significant unmet need for cardiac rehabilitation in Iran, with only 1 spot available for every 7 incident AMI patients annually.
Reveals major geographic inequities in cardiac rehabilitation access in Iran; leaves open effects on post-AMI outcomes and optimal expansion strategies.
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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Sadeghi et al. (2023) conducted a cross-sectional in Cardiac rehabilitation (n=22). Cardiac rehabilitation programs was evaluated on Availability, density, and unmet need for cardiac rehabilitation. Cardiac rehabilitation services are available in only 12 of 31 Iranian provinces (38.7%), with a national density of 1 spot per 7 incident AMI patients per year, highlighting a massive unmet need.
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