Korean J Thorac Cardiovasc Surg.  2019 Aug;52(4):248-285. 10.5090/kjtcs.2019.52.4.248.

Clinical Practice Guideline for Cardiac Rehabilitation in Korea

• Kim C
• Sung J
• Lee JH
• Kim WS
• Lee GJ
• Jee S
• Jung IY
• Rah UW
• Kim BO
• Choi KH
• Kwon BS
• Yoo SD
• Bang HJ
• Shin HI
• Kim YW
• Jung H
• Kim EJ
• Lee JH
• Jung IH
• Jung JS
• Lee JY
• Han JY
• Han EY
• Won YH
• Han W
• Baek S
• Joa KL
• Lee SJ
• Kim AR
• Lee SY
• Kim J
• Choi HE
• Lee BJ
• Kim S

• KMID: 2455154
• DOI: http://doi.org/10.5090/kjtcs.2019.52.4.248

Abstract

BACKGROUND
Though clinical practice guidelines (CPGs) for cardiac rehabilitation (CR) are an effective and widely used treatment method worldwide, they are as yet not widely accepted in Korea. Given that cardiovascular disease is the second leading cause of death in Korea, it is urgent that CR programs be developed. In 2008, the Government of Korea implemented CR programs at 11 university hospitals as part of its Regional Cardio-Cerebrovascular Center Project, and 3 additional medical facilities will be added in 2019. In addition, owing to the promotion of CR nationwide and the introduction of CR insurance benefits, 40 medical institutions nationwide have begun CR programs even as a growing number of medical institutions are preparing to offer CR. The purpose of this research was to develop evidence-based CPGs to support CR implementation in Korea.
METHODS
This study is based on an analysis of CPGs elsewhere in the world, an extensive literature search, a systematic analysis of multiple randomized control trials, and a CPG management, development, and assessment committee comprised of 33 authors"”primarily rehabilitation specialists, cardiologists, and thoracic surgeons in 21 university hospitals and 2 general hospitals. Twelve consultants, primarily rehabilitation, sports medicine, and preventive medicine specialists, CPG experts, nurses, physical therapists, clinical nutritionists, and library and information experts participated in the research and development of these CPGs. After the draft guidelines were developed, 3 rounds of public hearings were held with staff members from relevant academic societies and stakeholders, after which the guidelines were further reviewed and modified.
RESULTS
CR involves a more cost-effective use of healthcare resources relative to that of general treatments, and the exercise component of CR lowers cardiovascular mortality and readmission rates, regardless of the type of coronary heart disease and type and setting of CR.
CONCLUSION
Individualized CR programs should be considered together with various factors, including differences in heart function and lifestyle, and doing so will boost participation and adherence with the CR program, ultimately meeting the final goals of the program, namely reducing the recurrence of myocardial infarction and mortality rates.

Keyword

Acute coronary syndrome; Cardiac rehabilitation; Mortality; Clinical practice guidelines; Secondary prevention

MeSH Terms

Acute Coronary Syndrome
Cardiovascular Diseases
Cause of Death
Consultants
Coronary Disease
Delivery of Health Care
Heart
Hospitals, General
Hospitals, University
Humans
Insurance Benefits
Korea*
Life Style
Methods
Mortality
Myocardial Infarction
Nutritionists
Physical Therapists
Preventive Medicine
Recurrence
Rehabilitation*
Secondary Prevention
Specialization
Sports Medicine
Surgeons