Dr Susan Cartledge

Breaking down the silos - a pathway from acute hospital care to cardiac rehabilitation. A pilot RCT to improve referral and uptake of cardiac rehabilitation

Dr Susan Cartledge, Monash University

2020 Postdoctoral Fellowship

Years funded: 2021-2022

Cardiac rehabilitation provides education and exercise over 6 – 8 weeks, ensuring those living with heart disease have critical self-management skills to reduce the risk of future events. Even though there is the highest level of evidence for cardiac rehabilitation, global attendance and completion of programs is poor. Australian and international statistics, for the past 20 years report that only 20-50% of eligible patients attend. This is particularly evident for patients with heart disease living in regional, rural and remote Australia. This is in part due to the modes of delivery for cardiac rehabilitation (face-to-face in-patient and out-patient sessions), which have changed little in 50 years.

My program of research will move cardiac rehabilitation into the 21st century through a new model of care delivery. I will develop and evaluate a standardised program that is evidence-based and delivered through multiple modalities to allow patients to choose how and when they attend and complete their cardiac rehabilitation program. Choices will include flexible options such as telephone, videoconference, web-based and via local General Practitioners in addition to traditional face-to-face programs. Importantly, participants can move between delivery methods as needed to complete their program. This new model of cardiac rehabilitation will be evaluated through the recently defined national cardiac rehabilitation quality indicators.

It is anticipated that this new flexible model of delivery will increase uptake and completion of programs, leading to better long-term health outcomes, prevent secondary events and improve quality of life for regional, rural and remote cardiac patients. The outcomes of this project will be scalable to all secondary prevention programs and will inform future national practice and policy to ensure increased reach of cardiac rehabilitation for all Australians.