Quality indicators for cardiac rehabilitation after myocardial infarction in China: a consensus panel and practice test
Jian Wu,
Min Zhang,
Bo Yu,
Shan Li,
Rongjing Ding,
Xianghui Zheng,
Maomao Zhang,
Yang Zheng,
Yongxiang Zhang,
Junnan Wang,
Xuwen Yang,
Gaowa Siqin,
Xinyu Hou,
Liangqi Chen,
Yong Sun
Affiliations
Jian Wu
Department of Neurology, Tiantai People`s Hospital of Zhejiang Province, Taizhou, China
Min Zhang
Department of Pathology, Gansu Provincial Hospital, Lanzhou, Gansu, China
Bo Yu
2 Cardiology, Key Laboratories of Education Ministry for Myocardial Ischemia Mechanism and Treatment, 2nd Affiliated Hospital of Harbin Medical University, Harbin, China
Shan Li
2Jiangsu Simcere Pharmaceutical Co., Ltd, Nanjing, China
Rongjing Ding
6 Department of Cardiology, Peiking University People’s Hospital, Beijing, China
Xianghui Zheng
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
Maomao Zhang
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
Yang Zheng
Department of Cardiology, The First Hospital of Jilin University, Changchun, China
Yongxiang Zhang
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
Junnan Wang
Department of Cardiology, the Second Hospital of Jilin University, Changchun, Jilin Province, China
Xuwen Yang
Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
Gaowa Siqin
Department of Cardiology, Inner Mongolia People`s Hospital, Huhhot, Inner Mongolia, China
Xinyu Hou
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
Liangqi Chen
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
Yong Sun
Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China
Objectives Cardiac rehabilitation (CR) improves outcomes after myocardial infarction (MI), but it is underused in China. The purpose of this study was to develop a set of quality indicators (QIs) to improve clinical practices and to confirm the measurability and performance of the developed QIs for CR in Chinese patients after MI.Design and setting The QIs were developed by a Chinese expert consensus panel during in-person meetings. The five QIs most in need of improvement were selected using a national questionnaire. Finally, the completion rate and feasibility of the QIs were verified in a group of MI survivors at university hospitals in China.Participants Seventeen professionals participated in the consensus panel, 89 personnel in the field of CR participated in the national questionnaire and 165 MI survivors participated in the practice test.Results A review of 17 eligible articles generated 26 potential QIs, among which 17 were selected by the consensus panel after careful evaluation. The 17 QIs were divided into two domains: (1) improving participation and adherence and (2) CR process standardisation. Nationwide telephone and WeChat surveys identified the five QIs most in need of improvement. A multicenter practice test (n=165) revealed that the mean performance value of the proposed QIs was 43.9% (9.9%–86.1%) according to patients with post-MI.Conclusions The consensus panel identified a comprehensive set of QIs for CR in patients with post-MI. A nationwide questionnaire survey was used to identify the QIs that need immediate attention to improve the quality of CR. Although practice tests confirmed the measurability of the proposed QIs in clinical practice, the implementation of the QIs needs to be improved.Trial registration number This study is part of a study registered in ClinicalTrials.gov (NCT03528382).
