Exploring the delivery of phase II cardiac rehabilitation services in rural and remote Australia: a scoping review.

Objective: Phase II cardiac rehabilitation (CR) reduces cardiovascular risk factors, morbidity and mortality after a cardiac event. Traditional Australian CR programs are located in metropolitan areas and delivered by an expert, multidisciplinary team. Referral and uptake barriers for people living in rural and remote locations are significantly affected by geographical isolation. This scoping review aimed to explore how phase II CR services in rural and remote Australia are being delivered. Methods: A scoping review was conducted to obtain all published literature relating to CR service delivery for people living in rural and remote Australia. A literature search of the following databases was performed in December 2021: Cumulative Index to Nursing and Allied Health Literature, Embase, the Physiotherapy Evidence Database, and PubMed. Results: Six articles met the inclusion criteria. Study designs varied and included mixed methods, cross-sectional design and narrative review. Overall, literature relating to CR programs in rural and remote Australia was limited. Three themes were apparent: (1) barriers to the delivery of phase II CR in rural and remote Australia remain; (2) community centre‐based programs do not reach all people in rural and remote Australia; and (3) alternative models of CR are underutilised. Conclusions: Phase II CR programs in rural and remote Australia do not align with current recommendations for service delivery. The use of technology as a primary or adjunct model of delivery to support people living in rural and remote Australia needs to be further developed and implemented. Further research exploring barriers to the uptake of alternative models of CR delivery is recommended. What is known about the topic? After a cardiac event, people living in rural and remote Australia face many barriers to cardiac rehabilitation (CR) attendance. What does this paper add? This paper demonstrates the need to improve CR service access provision in rural and remote Australia via alternate models of delivery. What are the implications for practitioners? Exploring barriers to and facilitators of the uptake of hybrid models of delivery is recommended to ensure that CR services reach and support all people living in rural and remote Australia after a cardiac event. [ABSTRACT FROM AUTHOR]