TY - JOUR
T1 - Implementation and prospective evaluation of the Country Heart Attack Prevention model of care to improve attendance and completion of cardiac rehabilitation for patients with cardiovascular diseases living in rural Australia
T2 - a study protocol
AU - CHAP Project Team
AU - Beleigoli, Alline
AU - Nicholls, Stephen J
AU - Brown, Alex
AU - Chew, Derek P
AU - Beltrame, John
AU - Maeder, Anthony
AU - Maher, Carol
AU - Versace, Vincent L
AU - Hendriks, Jeroen M
AU - Tideman, Philip
AU - Kaambwa, Billingsley
AU - Zeitz, Christopher
AU - Prichard, Ivanka J
AU - Tavella, Rosanna
AU - Tirimacco, Rosy
AU - Keech, Wendy
AU - Govin, Kay
AU - Nesbitt, Katie
AU - Du, Huiyun
AU - Champion, Stephanie
AU - Pinero de Plaza, Maria Alejandra
AU - Lynch, Imelda
AU - Poulsen, Vanessa
AU - Ludlow, Marie
AU - Wanguhu, Ken
AU - Meyer, Hendrika
AU - Krollig, Ali
AU - Gebremichael, Lemlem
AU - Green, Chloe
AU - Clark, Robyn A
N1 - © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/2/16
Y1 - 2022/2/16
N2 - INTRODUCTION: Despite extensive evidence of its benefits and recommendation by guidelines, cardiac rehabilitation (CR) remains highly underused with only 20%-50% of eligible patients participating. We aim to implement and evaluate the Country Heart Attack Prevention (CHAP) model of care to improve CR attendance and completion for rural and remote participants.METHODS AND ANALYSIS: CHAP will apply the model for large-scale knowledge translation to develop and implement a model of care to CR in rural Australia. Partnering with patients, clinicians and health service managers, we will codevelop new approaches and refine/expand existing ones to address known barriers to CR attendance. CHAP will codesign a web-based CR programme with patients expanding their choices to CR attendance. To increase referral rates, CHAP will promote endorsement of CR among clinicians and develop an electronic system that automatises referrals of in-hospital eligible patients to CR. A business model that includes reimbursement of CR delivered in primary care by Medicare will enable sustainable access to CR. To promote CR quality improvement, professional development interventions and an accreditation programme of CR services and programmes will be developed. To evaluate 12-month CR attendance/completion (primary outcome), clinical and cost-effectiveness (secondary outcomes) between patients exposed (n=1223) and not exposed (n=3669) to CHAP, we will apply a multidesign approach that encompasses a prospective cohort study, a pre-post study and a comprehensive economic evaluation.ETHICS AND DISSEMINATION: This study was approved by the Southern Adelaide Clinical Human Research Ethics Committee (HREC/20/SAC/78) and by the Department for Health and Wellbeing Human Research Ethics Committee (2021/HRE00270), which approved a waiver of informed consent. Findings and dissemination to patients and clinicians will be through a public website, online educational sessions and scientific publications. Deidentified data will be available from the corresponding author on reasonable request.TRIAL REGISTRATION NUMBER: ACTRN12621000222842.
AB - INTRODUCTION: Despite extensive evidence of its benefits and recommendation by guidelines, cardiac rehabilitation (CR) remains highly underused with only 20%-50% of eligible patients participating. We aim to implement and evaluate the Country Heart Attack Prevention (CHAP) model of care to improve CR attendance and completion for rural and remote participants.METHODS AND ANALYSIS: CHAP will apply the model for large-scale knowledge translation to develop and implement a model of care to CR in rural Australia. Partnering with patients, clinicians and health service managers, we will codevelop new approaches and refine/expand existing ones to address known barriers to CR attendance. CHAP will codesign a web-based CR programme with patients expanding their choices to CR attendance. To increase referral rates, CHAP will promote endorsement of CR among clinicians and develop an electronic system that automatises referrals of in-hospital eligible patients to CR. A business model that includes reimbursement of CR delivered in primary care by Medicare will enable sustainable access to CR. To promote CR quality improvement, professional development interventions and an accreditation programme of CR services and programmes will be developed. To evaluate 12-month CR attendance/completion (primary outcome), clinical and cost-effectiveness (secondary outcomes) between patients exposed (n=1223) and not exposed (n=3669) to CHAP, we will apply a multidesign approach that encompasses a prospective cohort study, a pre-post study and a comprehensive economic evaluation.ETHICS AND DISSEMINATION: This study was approved by the Southern Adelaide Clinical Human Research Ethics Committee (HREC/20/SAC/78) and by the Department for Health and Wellbeing Human Research Ethics Committee (2021/HRE00270), which approved a waiver of informed consent. Findings and dissemination to patients and clinicians will be through a public website, online educational sessions and scientific publications. Deidentified data will be available from the corresponding author on reasonable request.TRIAL REGISTRATION NUMBER: ACTRN12621000222842.
KW - Aged
KW - Australia
KW - Cardiac Rehabilitation/methods
KW - Cardiovascular Diseases
KW - Humans
KW - Myocardial Infarction
KW - National Health Programs
KW - Prospective Studies
U2 - 10.1136/bmjopen-2021-054558
DO - 10.1136/bmjopen-2021-054558
M3 - Article
C2 - 35173003
SN - 2044-6055
VL - 12
SP - e054558
JO - BMJ open
JF - BMJ open
IS - 2
ER -