Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission: A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia

A. Beleigoli; J. Foote; L. Gebremichael; N. Bulamu; C. Astley; W. Keech; R. Tavella; A. Gulyani; K. Nesbitt; M. Pinero de Plaza; J. Ramos; M. Ludlow; P. Tideman; S. Nicholls; D. Chew; J. Beltrame; R. Clark

doi:10.1016/j.hlc.2023.06.518

Abstract

Background
Cardiac rehabilitation (CR) evidence may not translate into practice due to low participation. We aimed to determine CR utilisation and effectiveness in South Australia.
Methods
This retrospective cohort study used data linkage between CR, hospitals and deaths databases and applied inverse probability weighting and adjusted Cox survival models to assess the association between CR utilisation (no CR received/commenced but not completed/completed) and 12-month all-cause mortality/cardiovascular readmissions. Associations with non-referral and non-completion were assessed by logistic regression.
Results
Among 84,064 eligible separations, 31.9% were referred to CR. Of these, 36.8% commenced the program with 77.8% of those commencing completing it. Median time from discharge to referral and from discharge to commencement was 6 (IQR 2-11) days and 40 (IQR 23-79) days, respectively. Female sex (OR 1.77; 95% CI 1.71-1.83; pConclusions
CR shows a dose-response effect on mortality/cardiovascular readmissions. Delivery via telehealth and tailoring referral systems and programs to the needs of women, disadvantaged and people with obesity may increase participation.

Original language	English
Article number	617
Pages (from-to)	s389
Number of pages	1
Journal	Heart, Lung and Circulation
Volume	32
Issue number	suppl 3
DOIs	https://doi.org/10.1016/j.hlc.2023.06.518
Publication status	Published - Jul 2023

Keywords

Cardiac rehabilitation
CR utilization
Cardiovascular outcomes
Telehealth delivery
Patient participation
Digital Health
Data analytics

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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ACvA CV Champion
Pinero de Plaza, M. A. (Recipient), 29 Aug 2022
Prize: Other distinction

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Awarded the ESSA Medal 2016 for the most outstanding PhD thesis
Ramos, J. (Recipient), 2020
Prize: Honorary award
A winner of the Big Ideas video competition to improve the Australian health system. Consumer Health Forum of Australia, 2021.
Pinero de Plaza, A. (Recipient), 23 Feb 2021
Prize: Other distinction

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5 Invited talk

The Country Heart Attack Prevention (CHAP) Project showcase: CR4ALL- Results, SAHMRI 2023.
Pinero de Plaza, M. A. (Speaker)
7 Jun 2023 → …
Activity: Talk or presentation types › Invited talk
How can research, advocacy, and innovation come together to improve digital health for better care?
Pinero de Plaza, M. A. (Speaker)
23 May 2023
Activity: Talk or presentation types › Invited talk

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HTSA's Consumer Engagement Summit Panel Session
Pinero de Plaza, M. A. (Speaker)
24 Oct 2023
Activity: Talk or presentation types › Invited talk

3 Meeting Abstract
3 Article
2 Review article
1 Poster

Clinical Effectiveness and Implementation Evaluation of a Large-Scale Translation Co-Designed Model on Cardiac Rehabilitation Attendance and Completion in Rural Australia Authors
Beleigoli, A., Gebremichael, L., Bulamu, N., Gulyani, A., Chew, D., Nicholls, S., Ramos, J., Maher, C., Beltrame, J., Kaambwa, B., Versace, V., Hendriks, J., Tavella, R., Foote, J., Nesbitt, K., Powell, S., Pinero de Plaza, M., Keech, W., Ludlow, M. & Maeder, A. & 7 others, Wanguhu, K., Meyer, H., Prichard, I., Suebkinorn, O., Zeitz, C., Brown, A. & Clark, R., Aug 2024, In: Heart Lung and Circulation. 33, Supplement 4, p. S226-S227 2 p.
Research output: Contribution to journal › Meeting Abstract › peer-review
CAREPULSE - Community And Rural Experts Partnered for Understanding and Leveraging Strategic Endeavours in Cardiac Rehabilitation and Secondary Prevention
Pinero de Plaza, D. M. A., Bester, C., Nesbitt, K., Hutchinson, C., Clark, R., Suebkinorn, O. & Beleigoli, A., 3 Nov 2023, (E-pub ahead of print) p. 1. 1 p.
Research output: Contribution to conference › Poster › peer-review

Open Access
File
62 Downloads (Pure)
Effectiveness of nurse-led interventions to manage hypertension and lifestyle behaviour effectively: a systematic review and meta-analysis
Bulto, L., Roseleur, J., Noonan, S., Pinero de Plaza, A., Champion, S., Dafny, H. A., Pearson, V., Nesbitt, K., Gebremichael, L., Beleigoli, A., Schultz, T., Hines, S., Clark, R. & Hendriks, J., Jun 2023, In: EP Europace. 25, Supplement 1, p. i1247 1 p.
Research output: Contribution to journal › Meeting Abstract › peer-review

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Cite this

Beleigoli, A., Foote, J., Gebremichael, L., Bulamu, N., Astley, C., Keech, W., Tavella, R., Gulyani, A., Nesbitt, K., Pinero de Plaza, M., Ramos, J., Ludlow, M., Tideman, P., Nicholls, S., Chew, D., Beltrame, J., & Clark, R. (2023). Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission: A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia. Heart, Lung and Circulation, 32(suppl 3), s389. Article 617. https://doi.org/10.1016/j.hlc.2023.06.518

Beleigoli, A. ; Foote, J. ; Gebremichael, L. et al. / Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission : A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia. In: Heart, Lung and Circulation. 2023 ; Vol. 32, No. suppl 3. pp. s389.

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title = "Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission: A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia",

abstract = "BackgroundCardiac rehabilitation (CR) evidence may not translate into practice due to low participation. We aimed to determine CR utilisation and effectiveness in South Australia.MethodsThis retrospective cohort study used data linkage between CR, hospitals and deaths databases and applied inverse probability weighting and adjusted Cox survival models to assess the association between CR utilisation (no CR received/commenced but not completed/completed) and 12-month all-cause mortality/cardiovascular readmissions. Associations with non-referral and non-completion were assessed by logistic regression.ResultsAmong 84,064 eligible separations, 31.9% were referred to CR. Of these, 36.8% commenced the program with 77.8% of those commencing completing it. Median time from discharge to referral and from discharge to commencement was 6 (IQR 2-11) days and 40 (IQR 23-79) days, respectively. Female sex (OR 1.77; 95% CI 1.71-1.83; pConclusionsCR shows a dose-response effect on mortality/cardiovascular readmissions. Delivery via telehealth and tailoring referral systems and programs to the needs of women, disadvantaged and people with obesity may increase participation.",

keywords = "Cardiac rehabilitation, CR utilization, Cardiovascular outcomes, Telehealth delivery, Patient participation, Digital Health, Data analytics",

author = "A. Beleigoli and J. Foote and L. Gebremichael and N. Bulamu and C. Astley and W. Keech and R. Tavella and A. Gulyani and K. Nesbitt and {Pinero de Plaza}, M. and J. Ramos and M. Ludlow and P. Tideman and S. Nicholls and D. Chew and J. Beltrame and R. Clark",

year = "2023",

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language = "English",

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Beleigoli, A, Foote, J, Gebremichael, L , Bulamu, N , Astley, C, Keech, W, Tavella, R, Gulyani, A , Nesbitt, K , Pinero de Plaza, M , Ramos, J, Ludlow, M, Tideman, P, Nicholls, S, Chew, D, Beltrame, J & Clark, R 2023, 'Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission: A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia', Heart, Lung and Circulation, vol. 32, no. suppl 3, 617, pp. s389. https://doi.org/10.1016/j.hlc.2023.06.518

Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission: A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia. / Beleigoli, A.; Foote, J.; Gebremichael, L. et al.
In: Heart, Lung and Circulation, Vol. 32, No. suppl 3, 617, 07.2023, p. s389.

Research output: Contribution to journal › Meeting Abstract › peer-review

TY - JOUR

T1 - Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission

T2 - A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia

AU - Beleigoli, A.

AU - Foote, J.

AU - Gebremichael, L.

AU - Bulamu, N.

AU - Astley, C.

AU - Keech, W.

AU - Tavella, R.

AU - Gulyani, A.

AU - Nesbitt, K.

AU - Pinero de Plaza, M.

AU - Ramos, J.

AU - Ludlow, M.

AU - Tideman, P.

AU - Nicholls, S.

AU - Chew, D.

AU - Beltrame, J.

AU - Clark, R.

PY - 2023/7

Y1 - 2023/7

N2 - BackgroundCardiac rehabilitation (CR) evidence may not translate into practice due to low participation. We aimed to determine CR utilisation and effectiveness in South Australia.MethodsThis retrospective cohort study used data linkage between CR, hospitals and deaths databases and applied inverse probability weighting and adjusted Cox survival models to assess the association between CR utilisation (no CR received/commenced but not completed/completed) and 12-month all-cause mortality/cardiovascular readmissions. Associations with non-referral and non-completion were assessed by logistic regression.ResultsAmong 84,064 eligible separations, 31.9% were referred to CR. Of these, 36.8% commenced the program with 77.8% of those commencing completing it. Median time from discharge to referral and from discharge to commencement was 6 (IQR 2-11) days and 40 (IQR 23-79) days, respectively. Female sex (OR 1.77; 95% CI 1.71-1.83; pConclusionsCR shows a dose-response effect on mortality/cardiovascular readmissions. Delivery via telehealth and tailoring referral systems and programs to the needs of women, disadvantaged and people with obesity may increase participation.

AB - BackgroundCardiac rehabilitation (CR) evidence may not translate into practice due to low participation. We aimed to determine CR utilisation and effectiveness in South Australia.MethodsThis retrospective cohort study used data linkage between CR, hospitals and deaths databases and applied inverse probability weighting and adjusted Cox survival models to assess the association between CR utilisation (no CR received/commenced but not completed/completed) and 12-month all-cause mortality/cardiovascular readmissions. Associations with non-referral and non-completion were assessed by logistic regression.ResultsAmong 84,064 eligible separations, 31.9% were referred to CR. Of these, 36.8% commenced the program with 77.8% of those commencing completing it. Median time from discharge to referral and from discharge to commencement was 6 (IQR 2-11) days and 40 (IQR 23-79) days, respectively. Female sex (OR 1.77; 95% CI 1.71-1.83; pConclusionsCR shows a dose-response effect on mortality/cardiovascular readmissions. Delivery via telehealth and tailoring referral systems and programs to the needs of women, disadvantaged and people with obesity may increase participation.

KW - Cardiac rehabilitation

KW - CR utilization

KW - Cardiovascular outcomes

KW - Telehealth delivery

KW - Patient participation

KW - Digital Health

KW - Data analytics

U2 - 10.1016/j.hlc.2023.06.518

DO - 10.1016/j.hlc.2023.06.518

M3 - Meeting Abstract

SN - 1443-9506

VL - 32

SP - s389

JO - Heart, Lung and Circulation

JF - Heart, Lung and Circulation

IS - suppl 3

M1 - 617

ER -

Beleigoli A, Foote J, Gebremichael L , Bulamu N , Astley C, Keech W et al. Improving Cardiac Rehabilitation Utilisation is Essential to Reducing Mortality and Cardiovascular Readmission: A Data Linkage Analysis of Cardiac Rehabilitation Utilisation and Clinical Outcomes of 84,064 Eligible Separations in South Australia. Heart, Lung and Circulation. 2023 Jul;32(suppl 3):s389. 617. doi: 10.1016/j.hlc.2023.06.518