A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure

Abstract Background There is a longstanding research-to-practice gap in the delivery of cardiac rehabilitation for patients with heart failure. Despite adequate evidence confirming that comprehensive cardiac rehabilitation can improve quality of life and decrease morbidity and mortality in heart fai...

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Autores principales:	Paulina Daw, Thomas M. Withers, Jet J. C. S. Veldhuijzen van Zanten, Alexander Harrison, Colin J. Greaves
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cardiac rehabilitation Heart failure Implementation science Systematic review Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/8fac48c3c0c04959a8796e111822cf6c
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spelling	oai:doaj.org-article:8fac48c3c0c04959a8796e111822cf6c2021-11-28T12:07:57ZA systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure10.1186/s12913-021-07174-w1472-6963https://doaj.org/article/8fac48c3c0c04959a8796e111822cf6c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07174-whttps://doaj.org/toc/1472-6963Abstract Background There is a longstanding research-to-practice gap in the delivery of cardiac rehabilitation for patients with heart failure. Despite adequate evidence confirming that comprehensive cardiac rehabilitation can improve quality of life and decrease morbidity and mortality in heart failure patients, only a fraction of eligible patients receives it. Many studies and reviews have identified patient-level barriers that might contribute to this disparity, yet little is known about provider- and system-level influences. Methods A systematic review using narrative synthesis. The aims of the systematic review were to a) determine provider- and system-level barriers and enablers that affect the delivery of cardiac rehabilitation for heart failure and b) juxtapose identified barriers with possible solutions reported in the literature. A comprehensive search strategy was applied to the MEDLINE, Embase, PsycINFO, CINAHL Plus, EThoS and ProQuest databases. Articles were included if they were empirical, peer-reviewed, conducted in any setting, using any study design and describing factors influencing the delivery of cardiac rehabilitation for heart failure patients. Data were synthesised using inductive thematic analysis and a triangulation protocol to identify convergence/contradiction between different data sources. Results Seven eligible studies were identified. Thematic analysis identified nine overarching categories of barriers and enablers which were classified into 24 and 26 themes respectively. The most prevalent categories were ‘the organisation of healthcare system’, ‘the organisation of cardiac rehabilitation programmes’, ‘healthcare professional’ factors and ‘guidelines’. The most frequent themes included ‘lack of resources: time, staff, facilities and equipment’ and ‘professional’s knowledge, awareness and attitude’. Conclusions Our systematic review identified a wide range of provider- and system-level barriers impacting the delivery of cardiac rehabilitation for heart failure, along with a range of potential solutions. This information may be useful for healthcare professionals to deliver, plan or commission cardiac rehabilitation services, as well as future research.Paulina DawThomas M. WithersJet J. C. S. Veldhuijzen van ZantenAlexander HarrisonColin J. GreavesBMCarticleCardiac rehabilitationHeart failureImplementation scienceSystematic reviewPublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cardiac rehabilitation Heart failure Implementation science Systematic review Public aspects of medicine RA1-1270
spellingShingle	Cardiac rehabilitation Heart failure Implementation science Systematic review Public aspects of medicine RA1-1270 Paulina Daw Thomas M. Withers Jet J. C. S. Veldhuijzen van Zanten Alexander Harrison Colin J. Greaves A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
description	Abstract Background There is a longstanding research-to-practice gap in the delivery of cardiac rehabilitation for patients with heart failure. Despite adequate evidence confirming that comprehensive cardiac rehabilitation can improve quality of life and decrease morbidity and mortality in heart failure patients, only a fraction of eligible patients receives it. Many studies and reviews have identified patient-level barriers that might contribute to this disparity, yet little is known about provider- and system-level influences. Methods A systematic review using narrative synthesis. The aims of the systematic review were to a) determine provider- and system-level barriers and enablers that affect the delivery of cardiac rehabilitation for heart failure and b) juxtapose identified barriers with possible solutions reported in the literature. A comprehensive search strategy was applied to the MEDLINE, Embase, PsycINFO, CINAHL Plus, EThoS and ProQuest databases. Articles were included if they were empirical, peer-reviewed, conducted in any setting, using any study design and describing factors influencing the delivery of cardiac rehabilitation for heart failure patients. Data were synthesised using inductive thematic analysis and a triangulation protocol to identify convergence/contradiction between different data sources. Results Seven eligible studies were identified. Thematic analysis identified nine overarching categories of barriers and enablers which were classified into 24 and 26 themes respectively. The most prevalent categories were ‘the organisation of healthcare system’, ‘the organisation of cardiac rehabilitation programmes’, ‘healthcare professional’ factors and ‘guidelines’. The most frequent themes included ‘lack of resources: time, staff, facilities and equipment’ and ‘professional’s knowledge, awareness and attitude’. Conclusions Our systematic review identified a wide range of provider- and system-level barriers impacting the delivery of cardiac rehabilitation for heart failure, along with a range of potential solutions. This information may be useful for healthcare professionals to deliver, plan or commission cardiac rehabilitation services, as well as future research.
format	article
author	Paulina Daw Thomas M. Withers Jet J. C. S. Veldhuijzen van Zanten Alexander Harrison Colin J. Greaves
author_facet	Paulina Daw Thomas M. Withers Jet J. C. S. Veldhuijzen van Zanten Alexander Harrison Colin J. Greaves
author_sort	Paulina Daw
title	A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
title_short	A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
title_full	A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
title_fullStr	A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
title_full_unstemmed	A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
title_sort	systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure
publisher	BMC
publishDate	2021
url	https://doaj.org/article/8fac48c3c0c04959a8796e111822cf6c
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A systematic review of provider-and system-level factors influencing the delivery of cardiac rehabilitation for heart failure

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