A systematic review of cardiac rehabilitation registries

Abstract

Introduction: Despite cardiac rehabilitation (CR) being recommended in clinical practice guidelines internationally these services are under-utilised, programs are not standardised and quality improvement methods and outcomes are rarely published. National registries are an important strategy to characterise service delivery, quality and outcomes, yet the number, type and components of national CR registries has not been reported. Aims: To identify and describe national and international CR registries internationally, and summarise their key features. Methods: The literature reporting on CR registries used to monitor the quality of CR at a national and international-level was systematically reviewed. A search of four databases was conducted in July 2016, with two reviewers independently screening title/abstracts and full-texts for inclusion. Data were extracted from included studies, independently checked by a second reviewer and synthesised qualitatively. Results: Eleven articles were included in the review comprising seven national registries and one international registry (of 12 European countries) for a total sample of 265,608 patients. Data were most commonly provided to the registry via a web-based application, and included individual-level data (i.e., sociodemographic characteristics, medical history, and clinical measurements). When reported, service-level data most commonly included wait times, program enrolment and completion. The overarching governance, funding modes (e.g., industry (n=2), government (n=1)), and incentives for registry participation (e.g., benchmarking, financial reimbursement, or mandatory requirement) varied widely. Conclusion: The use of national and international registries for characterising CR and providing a benchmark for quality improvement is in its early stages but shows promise for national and global benchmarking. Keywords: Acute coronary syndrome; cardiovascular disease, health information systems; quality Improvement