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The BACPR would like to thank the ICCPR for their recent letter highlighting the work undertaken by both organisations. We are reassured to learn that the results of the ICCPR survey are similar to our own . Both studies, conducted to support cardiovascular prevention and rehabilitation programmes, found that half of all cardiac rehabilitation services were cancelled during the first wave of COVID-19 (~March to June 2020). This is concerning because the closure of so many cardiac rehabilitation programmes is likely to have had a significant negative effect on patient outcomes, cause avoidable hospital admissions, and undermine government efforts to reduce the pressure on acute hospital and healthcare services, during the COVID-19 pandemic. We agree with the ICCPR that further work is needed to investigate whether cardiac rehabilitation services have been restored. The BACPR remain committed to undertaking research that guides decision making and would be happy to explore opportunities with the ICCPR to combine existing research datasets and conduct future collaborative projects.
We believe that it is essential that government, governing bodies, and local policy makers, support cardiac rehabilitation teams to resume the delivery of effective services. Whilst restrictions on face-to-face human contact remain in place, services should be supported to adopt and refine remotely delivered models of cardiac rehabilitation. As we demonstrate in our survey , significan...
We believe that it is essential that government, governing bodies, and local policy makers, support cardiac rehabilitation teams to resume the delivery of effective services. Whilst restrictions on face-to-face human contact remain in place, services should be supported to adopt and refine remotely delivered models of cardiac rehabilitation. As we demonstrate in our survey , significant progress has been made in this regard and the BACPR are hopeful that the COVID-19 pandemic will catalyse a change in the way cardiac rehabilitation is delivered around the world, in the longer-term. Improving access to high quality home-based cardiac rehabilitation could enable more people to participate in this vital part of their cardiac recovery. As discussed in our survey , a concerted effort should be made to eliminate the barriers relating to remotely delivered cardiac rehabilitation. The BACPR will be working hard to ensure that this vital message is not lost as countries around the world eventually begin to recover from the effects of COVID-19.
1. O'Doherty, A., F., et al., How has technology been used to deliver cardiac rehabilitation during the COVID-19 pandemic? An international cross-sectional survey of healthcare professionals conducted by the BACPR. BMJ Open, 2021. 11:e046051.
The International Council of Cardiovascular Prevention and Rehabilitation (ICCPR) congratulates the British Association of Cardiovascular Prevention and Rehabilitation (BACPR), a foundational member, in providing an informative report on the effects of COVID-19 on the delivery of cardiac rehabilitation (CR). ICCPR is looking forward to providing further peer-reviewed data soon to add to these important findings.
Indeed, ICCPR’s soon-to-be published international survey of CR programs corroborates findings from BACPR’s study; we collated responses from over 1,000 programs in 70 countries (or 63% of those known to have CR in the world) and similarly found half of programs had been closed. Based on estimates of the number of CR programs available from our global audit (https://globalcardiacrehab.com/Global-CR-Program-Survey) and those temporarily shuttered, this would translate to 4400 programs being closed globally last Spring.
Results from our survey also showed drastic increases in use of videoconferencing, but this work by BACPR provides much more information for the CR community on the use of technology for various components of CR.
We also reported on the major impacts of the pandemic on staff from an occupational and psychosocial perspective. The pre-print of this work is available here: https://www.medrxiv...
We also reported on the major impacts of the pandemic on staff from an occupational and psychosocial perspective. The pre-print of this work is available here: https://www.medrxiv.org/content/10.1101/2020.11.11.20230045v1) and is currently in press in Global Heart.
Given how the pandemic has evolved and the variation in vaccination penetration globally, it would be informative to get a more current assessment of the impact of COVID-19 on CR delivery. In the meantime, ICCPR works to support the CR community by collating the latest COVID-19 resources and research on our website (see: https://globalcardiacrehab.com/COVID-19). We are encouraged by the continually accumulating evidence on the efficacy of remote CR pre and peri-pandemic.
We remain dedicated to augmenting CR capacity and access, considering also that many COVID-19 survivors with cardiorespiratory sequelae (i.e., so-called “long-COVID” and “COVID long-haulers”) may also be in need of our services. We conclude with a call to the CR community for research on the effects of CR in this population, and for dialogue on ways we might accommodate these patients where warranted by evidence.