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Ferrel-Yui D, Candelaria D, Pettersen TR, Gallagher R, Shi W. Uptake and implementation of cardiac telerehabilitation: A systematic review of provider and system barriers and enablers. Int J Med Inform 2024; 184:105346. [PMID: 38281451 DOI: 10.1016/j.ijmedinf.2024.105346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/20/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Cardiac telerehabilitation has demonstrated effectiveness for patient health outcomes, but uptake and implementation into practice have been limited and variable. While patient-level influences on uptake have been identified, little is known about provider- and system-level factors. AIMS To identify provider and system barriers and enablers to uptake and implementation of cardiac telerehabilitation. METHODS A systematic review was conducted, including a search of six databases (MEDLINE, Embase, CINAHL, Scopus, Web of Science, and PsycINFO) from 2000 to March 2023. Two reviewers independently screened eligible articles. Study quality was evaluated according to study design by the Critical Appraisal Skills Programme (CASP) checklist for qualitative data, the Appraisal Tool for Cross-sectional Studies (AXIS), and the Mixed Methods Appraisal Tool (MMAT) for mixed methods. Data were analysed using narrative synthesis. RESULTS Twenty eligible studies (total 1674 participants) were included. Perceived provider-level barriers included that cardiac telerehabilitation is resource intensive, inferior to centre-based delivery, and lack of staff preparation. Whereas provider-level enablers were having access to resources, adequate staff preparation, positive staff beliefs regarding cardiac telerehabilitation and positive team dynamics. System-level barriers related to unaligned policy, healthcare system and insurance structures, technology issues, lack of plans for implementation, and inadequate resources. System-level enablers included cost-effectiveness, technology availability, reliability, and adaptability, and adequate program development, implementation planning and leadership support. CONCLUSIONS Barriers and enablers at both provider and system levels must be recognised and addressed at the local context to ensure better uptake of cardiac telerehabilitation programs.
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Affiliation(s)
- Daniel Ferrel-Yui
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia
| | - Dion Candelaria
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia; The University of Sydney, Charles Perkins Centre, D17, John Hopkins Drive, Camperdown, New South Wales, 2050, Australia.
| | - Trond Røed Pettersen
- Haukeland University Hospital, Department of Heart Disease, Box 1400, 5021, Bergen, Norway
| | - Robyn Gallagher
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia; The University of Sydney, Charles Perkins Centre, D17, John Hopkins Drive, Camperdown, New South Wales, 2050, Australia
| | - Wendan Shi
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, D18, Western Avenue, Camperdown, New South Wales 2050, Australia; The University of Sydney, Charles Perkins Centre, D17, John Hopkins Drive, Camperdown, New South Wales, 2050, Australia; St George Hospital, Centre for Research in Nursing and Health, Gray Street, Kogarah, New South Wales 2217, Australia
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Nery RM, dos Santos AC, Garcia EL. Exercise-Based Cardiac Rehabilitation (ECBR): New Frontiers in the Post-Novel Coronavirus. Arq Bras Cardiol 2023; 120:e20230120. [PMID: 37042881 PMCID: PMC10392857 DOI: 10.36660/abc.20230120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Affiliation(s)
- Rosane Maria Nery
- Hospital de Clínicas de Porto AlegreGrupo de pesquisa em cardiologia do exercícioPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Grupo de pesquisa em cardiologia do exercício (CardioEx), Porto Alegre, RS – Brasil
- Hospital de Clínicas de Porto AlegreGrupo de pesquisa em cirurgia vascular e exercícioPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Grupo de pesquisa em cirurgia vascular e exercício (VascoEx), Porto Alegre, RS – Brasil
- Hospital de Clínicas de Porto AlegreServiço de fisiatria e reabilitaçãoPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Serviço de fisiatria e reabilitação, Porto Alegre, RS – Brasil
| | - Antonio Cardoso dos Santos
- Hospital de Clínicas de Porto AlegreServiço de fisiatria e reabilitaçãoPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Serviço de fisiatria e reabilitação, Porto Alegre, RS – Brasil
- Universidade Federal do Rio Grande do SulDepartamento de cirurgiaPorto AlegreRSBrasilUniversidade Federal do Rio Grande do Sul, Departamento de cirurgia, Porto Alegre, RS – Brasil
| | - Eduardo Lima Garcia
- Hospital de Clínicas de Porto AlegreGrupo de pesquisa em cirurgia vascular e exercícioPorto AlegreRSBrasilHospital de Clínicas de Porto Alegre – Grupo de pesquisa em cirurgia vascular e exercício (VascoEx), Porto Alegre, RS – Brasil
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