New AHRQ Project Designed to Save Lives By Increasing Use of Cardiac Rehabilitation after Coronary Events
Press Release Date: April 16, 2019
The Agency for Healthcare Research and Quality (AHRQ) today announced a $6 million, 3-year project designed to save lives by increasing patient participation in cardiac rehabilitation after cardiovascular events such as heart attacks, heart failure, angioplasty, or heart surgery.
Cardiac rehabilitation programs help patients return to an active lifestyle through medically supervised education, exercise training and psychological support. However, only 20 percent of the nearly one million Americans who experience a qualifying event each year participate in cardiac rehabilitation despite evidence that doing so saves lives and reduces healthcare costs. Older and sicker patients, women, minorities and patients with lower socioeconomic status or education may be even less likely to participate.
“For us to achieve patient-centered healthcare for cardiac patients, we must ensure that more of them are enrolled in life-saving cardiac rehabilitation services,” said Gopal Khanna, M.B.A., AHRQ’s director. “This effort will tackle the problem in several ways, including not just on-the-ground training, but also development of an online platform to curate and promote urgently needed resources.”
It is estimated that increasing cardiac rehabilitation participation from about 20 percent to 70 percent could save nearly 25,000 lives and prevent about 180,000 hospitalizations a year. Research suggests that cardiac rehabilitation reduces cardiovascular deaths by nearly 30 percent and risk of hospital admissions by 31 percent.
Low rates of referrals to rehabilitation may be attributable to several factors. Some clinicians may have limited awareness of cardiac rehabilitation’s benefits. Even when referrals are made, patients often don’t enroll or leave rehabilitation prematurely. Reasons for this include a lack of follow-up with primary care clinicians, competing work or home responsibilities, and scarcity of programs in rural areas or low-income communities. In addition, some programs don’t address the needs of women, language barriers or the need for cultural sensitivity.
AHRQ’s new initiative will be implemented under a contract awarded to Abt Associates. It will tackle the problem in several ways, including partnering with and training of at least 100 hospitals and health systems to increase rehabilitation referrals, enrollment and retention.
These efforts will apply strategies in the new Million Hearts®/AACVPR Cardiac Rehabilitation Change Package, a quality improvement action guide developed by the Centers for Disease Control and Prevention (CDC) and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR).
Using this guide developed by CDC and AACVPR, the project will engage receptive hospitals to initially adopt two strategies proven to increase cardiac rehabilitation participation: automated referrals of patients who qualify, and a trained liaison to help make the referrals happen.
“We are thrilled that AHRQ is supporting the implementation of our evidence-based Cardiac Rehabilitation Change Package. Their leadership to increase participation in cardiac rehabilitation for patients will meaningfully contribute to the national target of achieving 70 percent participation. It will ultimately help reach the Million Hearts® 2022 goal of preventing one million heart attacks and strokes and, more broadly, help more Americans live longer and healthier lives,” said Betsy L. Thompson, M.D., M.S.P.H., Dr.P.H., Director, Division of Heart Disease and Stroke Prevention, CDC.
Hospitals participating in the initiative, as well as others that join a new learning network, will also benefit from a website that will emphasize the negative impacts of cardiac rehabilitation underuse, the value of increased utilization, and the availability of existing resources to promote referrals, enrollment and retention.
AHRQ’s new project, funded by the Patient-Centered Outcomes Research Trust Fund, advances AHRQ’s initiatives to enhance heart health. It also will contribute to the national Million Hearts® 2022 initiative, co-led by the CDC and the Centers for Medicare & Medicaid Services.
Contact: AHRQ Office of Communications