Factors Associated With Non-enrollment of Center-Based Cardiovascular Rehabilitation Program Among Transient Ischemic Attack or Mild Stroke Patients: A MIXED-METHOD RETROSPECTIVE STUDY

Perspectives of cardiac rehabilitation in patients who had a stroke: a protocol for a qualitative study review

INTRODUCTION

Stroke has a high incidence and disability rate, and its recurrence and readmission rates are rising, making it the second-leading cause of mortality in the globe. Cardiac rehabilitation is a well-known, evidence-based strategy that might serve as an additional preventative programme. Prior quantitative research has proven the positive results and high practicability of cardiac rehabilitation for patients who had a stroke, however, cardiac rehabilitation is not yet a routine component of stroke rehabilitation worldwide. It might be useful to conduct meta-integration of previous qualitative studies to understand if existing cardiac rehabilitation programme meets the needs of patients who had a stroke. Therefore, the purpose of this study is to combine systematically the perspectives on benefits, barriers and facilitating factors of cardiac rehabilitation in patients who had a stroke.

METHODS AND ANALYSIS

There will be a search of PubMed, Web of Science, Embase, Scopus, CINAHL and PsycINFO databases. In addition, grey literature from Google Scholar, OpenGrey, PyARXiv, bioRxiv and medRxiv will also be searched. Included studies will be qualitative studies or findings from mixed-method research involving patients who engage in CR after a stroke. Regardless of the publishing date and context, English-language articles will be reviewed. Two impartial reviewers will screen studies and extract data from the included studies. According to the Joanna Briggs Institute Centre for Evidence-Based Health Care Quality Evaluation Criteria for qualitative research, the methodology of the included literature will be examined. For data synthesis, the pooling meta-integration approach and Noblit and Hare's seven steps of meta-ethnography will be used.

ETHICS AND DISSEMINATION

Because there will be no collection of primary data, this systematic review is exempt from the need that gets ethical approval. The findings of the review will be made public by publishing them in scholarly journals and presenting them at scientific conferences.

PROSPERO REGISTRATION NUMBER

CRD42023387534.

Trends in outpatient rehabilitation practices in Japan: analysis using the National Database of Health Insurance Claims Open Data

Objective: Many countries have recently established registration databases in the field of rehabilitation to clarify their current status. However, these databases are primarily created for inpatients, with only a few large-scale databases for outpatients. The present study aimed to clarify secular changes, age distribution, and regional disparities in the implementation of outpatient rehabilitation in Japan using the National Database of Health Insurance Claims.

Materials and Methods: Using the National Database of Health Insurance Claims Open Data published by the Ministry of Health, Labor, and Welfare, the number of outpatient rehabilitation units from 2014 to 2018 were extracted and examined.

Results: The total number of units for outpatient rehabilitation increased gradually from 2014 to 2018. Orthopedic rehabilitation accounted for more than 80% of the total number of units for outpatient rehabilitation in 2018. The total number of units for outpatient rehabilitation according to age was highest among those in their late 70s, while cerebrovascular and dysphagia rehabilitation had the highest number of units in children.

Conclusion: The total number of units for outpatient rehabilitation gradually increased from 2014 to 2018; whereas the number of total units for outpatient rehabilitation according to age was the highest among those in their late 70s. However, cerebrovascular rehabilitation and dysphagia rehabilitation had the highest number of units in children. The implementation status of rehabilitation in each region varied greatly among prefectures, suggesting the need for policy planning to eliminate regional disparities.