Professor Robyn Clark

The Country Heart Attack Prevention (CHAP) Project

Professor Robyn Clark, Flinders University

2018 Partnership Engagement Grant

Years funded: 2020-2022

Despite well-established, high level evidence supporting the proven benefits of risk factor modification, cardiac rehabilitation and secondary prevention programs (CR&SP), are greatly underutilized. An audit of 2,299 patients in Australia and New Zealand has demonstrated that of those eligible only 46% were referred and this evidence based practice gap represents an avoidable variation in care delivery.

In South Australia a recent audit of 24 public CR&CP services found that of the 49,909 eligible cardiac separations in 3 years, 30.1% were referred and of these 28.4% completed a program and 70% declined to attend.

To begin to reduce the gap between indication and implementation, our team has for more than a decade, have been gathering preliminary data and identifying important barriers, including lack of, clinician recommendation, auto-referral, or individualized CHOICE of program and a sustainable lifelong commitment to treatment and risk factor modification in partnership with a family physician.

With the support of the SA Translation Centre Cardiac Rehabilitation Group we have designed and preliminarily tested a four step model of care and clinical pathway to address these barriers. We intend, over a 3 year period, using translation science methodology to implement this model into practice to the most in need groups (i.e. rural and remote patients) and compare the outcomes (including cost effectiveness) with usual care. As demonstrated by our team and the proposed partners, this project has been overwhelming supported state-wide by consumers, policy makers and clinicians. On completion of this study and with the support of the Heart Foundation and National Translations groups we plan for this model to be normalized into practice for ALL eligible patients across Australia.