Implementing evidence-based guidelines & shared decision making tools to improve CVD prevention

Dr Emma Thomas, The University of Queensland

2020 Postdoctoral Fellowship

Years funded: 2021-2022

Cardiac rehabilitation enables people who have suffered a heart event to self-manage their condition and improve their quality of life. It reduces admissions to hospital and saves lives. However, many eligible patients (approximately 70 percent) do not attend. Some barriers to accessing facility-based programs (e.g. inflexible timing of program delivery, transport issues) can be solved through providing alternate delivery options. Telehealth-delivered cardiac rehabilitation has been shown to be as safe and effective as in-person delivery and is well-liked by patients. However, there is a practice-gap in translating these findings into clinical practice.

The aim of this post-doctoral program of research is to ultimately increase the number of people who attend cardiac rehabilitation. I will use a ‘learning health system’ approach to bring together information from the clinical registry data, clinician knowledge, and patient experience. I will identify areas in Queensland where there is low attendance at cardiac rehabilitation by using data from the Queensland Cardiac Outcome Registry. I will determine the nature and extent of telehealth-delivered cardiac rehabilitation in Queensland and the organisational capacity to facilitate telehealth use. A community of practice of patients, clinicians and researchers will be established to co-design an implementation plan to support cardiac rehabilitation services to implement telehealth.

The COVID-19 pandemic has provided a powerful push for clinicians to use alternate models of care. However, additional support is required to assist cardiac rehabilitation services in the transition to telehealth which includes support for technological requirements as well as change to workflow and care delivery. There is considerable potential to increase the reach of cardiac rehabilitation (and thereby reduce future cardiovascular events) by embedding telehealth into existing models of care.