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Breaking Barriers: Global study unveils fresh insights into cardiac rehab gender divide

Cardiovascular diseases have claimed the mantle of the world's leading cause of death, accounting for nearly one-third of all global fatalities. The concept of cardiac rehabilitation (CR) has emerged as a tailored programme designed to enhance the well-being of individuals grappling with heart issues or those with a history of cardiac surgery. The overarching goal of CR is to not only prevent but also reduce the risk of future heart conditions, thereby enhancing the overall quality of life. However, when it comes to CR, it is evident that women worldwide underutilize this resource compared to their male counterparts.

In a recent illuminating international study published in the esteemed Canadian Journal of Cardiology, researchers delved into the intricate realm of gender barriers within the domain of CR as well as the strategies aimed at mitigating these disparities. Their findings underscore that the gender barrier within CR is a multifaceted issue, demonstrating variations from one region to another. To effectively address this disparity, it becomes clear that tailored and personalised strategies must be deployed to break down these barriers and ensure equitable access to cardiac rehabilitation for all.

In this study, researchers investigated 2163 participants from 16 different countries, including 916 female participants. The findings of the study show that overall, women did not report any significant barriers in CR. However, participants from America and the Western Pacific region reported barriers in CR, while men in the Eastern Mediterranean reported higher barriers in CR. Women’s barriers were highest in the Western Pacific and Southeast Asian regions, where there was a lack of CR awareness in both regions.

Scientists found that unemployed participants are the greatest barrier in comparison to employed participants. The most common barriers among non-enrolled referred women were lack of awareness of CR, lack of connection with the programme, affordability, and tiredness after exercise. On the other hand, the greatest barrier to enrolled women was transportation, distance, and family duties. Mitigation strategies were very useful in improving session adherence.

Researchers suggest focusing on alleviating the difficulties faced by unemployed women.

Lead author Dr. Sherry L. Grace, Faculty of Health, York University and KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, said, “The benefits of cardiac rehab participation are remarkable, plus patients get back their vitality and can return to their meaningful life roles. Unfortunately, women face many structural barriers to attending, from the individual to the health system levels.”

"We developed the Cardiac Rehab Barriers Scale (CRBS) almost 25 years ago to better characterise them, and it remains the most widely used and rigorous measurement scale to assess these barriers,” said Dr. Grace.

She said, “We hope this will lead to more women enrolling in CR, and that would certainly positively impact their health outcomes and well-being.”

She advises the patients by saying, “Patients may have legitimate barriers to attending CR, but we recommend they discuss them with healthcare providers, as there are proven strategies to overcome them. Please help spread the word that CR is available in most countries of the world and saves lives."

Dr. Grace and co-researcher, Dr. Gabriela Ghisi, KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, emphasise the need for this comprehensive study by stating that it is important to conduct a global comparative study of CR in order to study the gender differences and women’s barriers so we can alleviate them and increase women's engagement in CR.

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