Evidence-based review for cardiac rehabilitation program development status and necessity in India

Abstract

India has a high burden of cardiovascular disease, morbidity and mortality due to CVD has been causing a high economic burden and leading to an overall increase in health care cost. Research evidence from different parts of the world indicates that structured approach to secondary prevention such as cardiac rehabilitation (CR) have health-favoring impact. When CR is supplemented with pharmacological interventions and percutaneous coronary intervention (PCI) has shown a significant improvement in quality of life, reduces morbidity, and mortality rate, cardiac-related parameters, depression and minimizes readmission rates among cardiac patients. Primarily, CR is delivered in three phases: Phase - I begin in the hospital, Phase - II outpatient phase, and Phase - III maintenance phase. Various organizations around the world deliver structured home-based and center-based CR program to cardiac patients also provides training and certification courses in CR to healthcare professionals (HCPs). However, in India, no such organization exists; therefore, CR delivery is under prevalent; further, other factors such as lack of skilled task force, adequate infrastructure, education, and training also contribute for suboptimal use of CR in the country. Awareness among HCPs and patients is also considered one of the primary factors to minimize the uptake of CR program in India. Therefore, there is a great need to revisit the CR delivery protocol and develop an evidence-based uniform approach to increase the uptake of the CR program. Government health care agencies should also frame guidelines to facilitating better infrastructure and training to resulting in increased uptake of CR program among cardiac patients. This review article has compiled various international studies to justify the benefits of CR program development necessity and status in India.