Nature, availability, and utilization of women-focused cardiac rehabilitation: a systematic review

• Published in: BMC cardiovascular disorders Vol. 21; no. 1; p. 459
• Main Authors: Mamataz, Taslima, Ghisi, Gabriela L M, Pakosh, Maureen, Grace, Sherry L
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 23-09-2021; BioMed Central; BMC
• Subjects: Adherence; Aged; Cardiac Rehabilitation; Cardiovascular disease; Coronary artery disease; Delivery of Health Care; Demographic aspects; Dissertations & theses; Female; Females; Gender; Health aspects; Health Services Accessibility; Health services utilization; Health Status Disparities; Healthcare Disparities; Healthcare utilization; Heart diseases; Heart Diseases - diagnosis; Heart Diseases - epidemiology; Heart Diseases - physiopathology; Heart Diseases - rehabilitation; Humans; Medicine, Preventive; Meta-analysis; Middle Aged; Mortality; Patient Satisfaction; Patient-Centered Care; Peer tutoring; Preventive health services; Recovery of Function; Rehabilitation; Risk Assessment; Risk Factors; Sex Factors; Systematic review; Treatment Outcome; Women; Women's Health Services; Womens health; Canada; Adherence; Women; Cardiac rehabilitation; Health services delivery; Satisfaction; Access; Secondary prevention; Systematic review; Healthcare utilization; Heart diseases
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-021-02267-0

Women do not participate in cardiac rehabilitation (CR) to the same degree as men; women-focused CR may address this. This systematic review investigated the: (1) nature, (2) availability, as well as (3a) utilization of, and (b) satisfaction with women-focused CR.
Medline, Pubmed, Embase, PsycINFO, CINAHL, Web of Science, Scopus and Emcare were searched for articles from inception to May 2020. Primary studies of any design were included. Adult females with any cardiac diseases, participating in women-focused CR (i.e., program or sessions included ≥ 50% females, or was 1-1 and tailored to women's needs) were considered. Two authors rated citations for inclusion. One extracted data, including study quality rated as per the Mixed-Methods Assessment Tool (MMAT), which was checked independently by a second author. Results were analyzed in accordance with the Synthesis Without Meta-analysis (SWiM) reporting guideline.
3498 unique citations were identified, with 28 studies (53 papers) included (3697 women; ≥ 10 countries). Globally, women-focused CR is offered by 40.9% of countries that have CR, with 32.1% of programs in those countries offering it. Thirteen (46.4%) studies offered women-focused sessions (vs. full program), 17 (60.7%) were women-only, and 11 (39.3%) had gender-tailoring. Five (17.9%) programs offered alternate forms of exercise, and 17 (60.7%) focused on psychosocial aspects. With regard to utilization, women-focused CR cannot be offered as frequently, so could be less accessible. Adherence may be greater with gender-tailored CR, and completion effects are not known. Satisfaction was assessed in 1 trial, and results were equivocal.
Women-focused CR involves tailoring of content, mode and/or sex composition. Availability is limited. Effects on utilization require further study.