Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative.
Increasing Cardiac Rehabilitation Participation From 20% to 70%: A Road Map From the Million Hearts Cardiac Rehabilitation Collaborative.
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DOI：
10.1016/j.mayocp.2016.10.014
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发表时间：
2017-02
影响因子：
8.9
通讯作者：
Thomas RJ
中科院分区：
文献类型：
--
作者：
Ades PA;Keteyian SJ;Wright JS;Hamm LF;Lui K;Newlin K;Shepard DS;Thomas RJ
“百万爱心”计划的主要目标是在 5 年内预防 100 万起心血管事件。百万之心致力于在阿司匹林“ABCS”、血压控制、胆固醇管理和戒烟等方面实现 70% 以上的表现，与此一致，我们概述了可以预防的心血管事件以及到 2022 年实现 70% 以上的心脏康复 (CR)/二级预防计划参与率的路线图。心脏康复是美国心脏协会和美国心脏病学会在心肌梗死后的 Ia 级建议或冠状动脉血运重建，促进 ABCS 以及生活方式咨询和锻炼，并与总死亡率、心脏死亡率和再住院率的降低相关。然而，目前美国CR的参与率一般只有20%到30%。该路线图重点关注干预措施，例如基于电子病历的提示和人员联络，以增加适当患者转诊至 CR、增加适当个人参加 CR 的人数以及提高长期 CR 的依从性。我们还计算出，将 CR 参与率从 20% 提高到 70% 将在美国每年挽救 25,000 人的生命并避免 180,000 人住院。
The primary aim of the Million Hearts initiative is to prevent 1 million cardiovascular events over 5 years. Concordant with the Million Hearts’ focus on achieving more than 70% performance in the “ABCS” of aspirin for those at risk, blood pressure control, cholesterol management, and smoking cessation, we outline the cardiovascular events that would be prevented and a road map to achieve more than 70% participation in cardiac rehabilitation (CR)/secondary prevention programs by the year 2022. Cardiac rehabilitation is a class Ia recommendation of the American Heart Association and the American College of Cardiology after myocardial infarction or coronary revascularization, promotes the ABCS along with lifestyle counseling and exercise, and is associated with decreased total mortality, cardiac mortality, and rehospitalizations. However, current participation rates for CR in the United States generally range from only 20% to 30%. This road map focuses on interventions, such as electronic medical record–based prompts and staffing liaisons that increase referrals of appropriate patients to CR, increase enrollment of appropriate individuals into CR, and increase adherence to longer-term CR. We also calculate that increasing CR participation from 20% to 70% would save 25,000 lives and prevent 180,000 hospitalizations annually in the United States.