Synopsis: 15

PROMOTION OF PATIENT PARTICIPATION IN CARDIAC REHABILITATION PROGRAMS BY DEVISING MODELS PERTINENT TO INDIAN POPULATION

Dr. Srihari Sharma K N

Dayanad Sagar University

Bangalore, Karnataka

The Indian subcontinent is estimated to bear the highest burden of Coronary artery disease (CAD) in the world.¹ An effective CAD program should ideally involve a multidisciplinary team approach.² Studies have clearly demonstrated that Cardiac Rehabilitation (CR) programs are able to meet the needs of the patient with a high degree of satisfaction.³ In spite of the documented benefits of CR, only a handful of eligible patients participate in such programs. In Europe, it was estimated that less than 20% of the patients attend the CR programs.⁴ In America, only 14% to 35% of heart attack survivors and 31% of post CABG patients participate in the programs and of them only 18% adhere to the programs. Similar published data in the Indian setting are not available.^5,6 Education level, spouse involvement, inadequate information are significant predictors of uptake of program.⁷ High intensity and poorly organized programs, patients who smoke and patients with more than one MI are major contributors for dropout from exercise programs.^{7 8} There is a need to design alternate systems of CR delivery including home based, facility-based rehabilitation and community based group programs monitored by non

physician health care providers and to improve reference to such centers.^4–6 Well organized, low to moderate intensity activities in the form of yoga is fast alluring the ethnic group and would be valuable in the enrollment of Indian patients into the rehabilitation programs in addition to ensure longer sustenance.⁹

The focus of the discussion would be on the various models that could be designed to ensure promotion of patient participation in CR programs in the Indian setting.