Developing a Collaborative Model for Cardiac Rehabilitation　― Linking Hospitals and Local Fitness Centers for Older Adults With Cardiovascular Disease ―

Abstract

Background: Cardiac rehabilitation (CR) is a comprehensive program designed to help cardiac patients reintegrate into social life. The maintenance phase (phase III) is typically conducted in hospitals or at local exercise facilities, depending on individual lifestyles. Effective collaboration between hospitals and local exercise facilities is essential for maintaining CR in older adults with cardiovascular disease (CVD), but several barriers hinder this linkage.

Methods and Results: Since 2022, the Aichi Health Plaza has maintained CR by developing a unique collaboration handbook (the Cardiac Rehabilitation Exercise Facility Cooperation Medical Institutions [CREpas] handbook). A collaboration system was established with the Department of Cardiology at the National Center for Geriatrics and Gerontology, facilitating seamless transitions through referrals after outpatient center-based CR. Partnerships included methods for information sharing, such as a collaboration diary, training records, occasional telephone calls and emails, and biannual information exchange meetings. A total of 18 collaboration patients was enrolled, and no severe adverse events occurred during exercise. However, 11 (61%) of the 18 patients discontinued the program for various reasons.

Conclusions: Transferring CR from hospitals to fitness centers is crucial for older adults with CVD. While safety was ensured at fitness centers, program interruptions highlight the need for addressing barriers to continuity. Seamless healthcare transitions for older CVD patients remain a key challenge in the context of the heart failure pandemic and require further discussion.