(P245) THE CURRENT STATE OF CARDIAC REHABILITATION IN B.C. AND THE YUKON: MENDING THE GAPS

Background: Cardiac rehabilitation (CR) is a specialized exercise and education program that reduces cardiovascular mortality by 26% and decreases hospital readmissions by 18% (Anderson et al., 2016). However, evidence shows that CR is under-utilized, with as few as 34% of eligible Canadian cardiac patients participating in a CR program (Grace et al., 2014). Currently, there is no provincial coordination or oversight for CR in B.C., and immense complexity in how services are funded and delivered. Cardiac Services BC conducted an environmental scan of CR services in B.C. and the Yukon to describe the current state and bring forth provincial considerations for program delivery.

METHODS AND RESULTS: Surveys were sent to established CR programs in B.C. and the Yukon. Responses were analyzed according to a set of core components developed by expert consensus, adherence with the Canadian Association of Cardiovascular Prevention and Rehabilitation (CACPR) Guidelines, and perceived barriers to service delivery.

Survey responses were received from all CR programs (35 responses representing 43 total programs) providing care to approximately 6000 patients annually. Variation was found among programs. Programs varied according to the CR indications accepted (Figure 1). Urban programs had more multidisciplinary teams (urban programs with multidisciplinary teams: 13/33, 39%), while more remote programs often relied on smaller teams (rural programs with multidisciplinary teams: 3/10, 30%). Most programs offered both education and exercise (28/43, 65%), in adherence with CACPR Guidelines, but with variation in the delivery models (i.e., in-person, virtual, or hybrid) (Table 1). Only 47% of respondent programs offered all six CR program core components surveyed.

Programs reported multifactorial barriers to equitable, high quality CR services including inability to meet demand; unsustainable staffing and funding models; and difficulty maintaining awareness of available services.

Conclusion: Despite the known health benefits of cardiac rehabilitation, CR programs within B.C. and the Yukon face significant challenges resulting in gaps in services, variation in access, and unsustainable models of care. Tackling the data void will help inform investment and open opportunities to leverage existing services and integrate hybrid models using expanded virtual options for care delivery. A robust provincial group of CR experts, including representation from Indigenous partners and people with lived experience, is needed to develop a CR service model that ensures cultural safety, equitable access, and quality.