First report of the International Council of Cardiovascular Prevention and Rehabilitation’s Registry (ICRR)

ABSTRACT

Objectives

Cardiac rehabilitation – programs comprehensively delivering outpatient secondary prevention – is under-available and under-studied in the resource-poor settings where it is needed most. This report summarizes the governance, participating sites, patient characteristics and outcomes, as well as knowledge translation activities during first year of operation of ICCPR’s registry, namely the International Cardiac Rehab Registry.

Methods

A pilot study was undertaken with five centers, demonstrating feasibility, satisfaction with the on-boarding processes, as well as data quality.

Results

Fourteen centers have been engaged from all regions but Europe; Data have been entered on >1000 patients (18.1% female; mean age = 57.6), of whom 62.4% completed their programs and 19.9% dropped out for work or clinical reasons. Post-program, completers had significantly better work status, functional capacity, medication adherence, physical activity levels, diet, as well as lower tobacco use than non-completers (all p < 0.05). A site Certification program was developed and piloted, with five centers now recognized for their quality, given they met over 70% of the 13 internationally agreed standards based on Registry data and a virtual site assessment.

Conclusion

Annual assessments have started. Quality improvement activities will soon be underway. We continue to invite new programs, supporting development in resource-poor settings to the benefit of patients served.

KEYWORDS:

• Cardiovascular diseases
• cardiac rehabilitation
• registries
• secondary prevention
• developing countries
• certification
• quality of health care
• outcome and process assessment

Supplemental data

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2023.2199154.

Abbreviations

(ICCPR)	=	International Council of Cardiovascular Prevention and Rehabilitation
(ICRR)	=	International Cardiac Rehab Registry
(CVD)	=	Cardiovascular disease
(LMICs)	=	Low and middle-income countries
(CR)	=	Cardiac rehabilitation
(SD)	=	Standard deviation
(CRT)	=	Cardiac resynchronization therapy
(ICD)	=	Implantable cardioverter-defibrillator
(LDL)	=	Low-density lipoprotein
(BMI)	=	Body mass index
(SBP)	=	Systolic blood pressure
(DBP)	=	Diastolic blood pressure
(METS)	=	Metabolic equivalent of task
(PHQ-2)	=	Patient Health Questionnaire-2

Acknowledgments

We are grateful to other members of ICCPR’s Program Certification Steering Committee: Emma Thomas, Jonathan David, Won-Seok Kim, Jon Gallagher, and Diann Gaalema. We appreciate the shared learnings and communication with other CR registries globally. Last but not least, we are grateful to other stewards entering data at participating cardiac rehabilitation centres, and the patients contributing data.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

SL Grace, K Turk-Adawi and A Contractor conceived the work, with SL Grace designing it. SL Grace and K Turk-Adawi secured funding. G Ghisi as well as K Turk-Adawi and SL Grace made substantial contributions to the acquisition of data; C Tran and F Raidah supported this acquisition as well as administration of the overall project. C Tran curated the data, and along with SL Grace analyzed the data, with SL Grace interpreting it. K Turk-Adawi, G Ghisi, M Heine, C Tran and SL Grace drafted sections of the work. C Tran drafted the display items for data visualization, following conception by SL Grace. All authors have given final approval of the version to be published. SL Grace agrees to be accountable for all aspects of the work.

Protocol registration

Clinical trial identifier is https://clinicaltrials.gov/ct2/show/NCT04676100.

Additional information

Funding

This work was supported by Qatar University International Research Collaboration Co-Fund (grant number IRCC-2020-005).