Jibril Mohammed Nuhu¹, Lubabatu Suleiman Gachi²

¹Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University, Kano, Nigeria.

²Department of Physiotherapy, Federal Medical Centre, Katsina, Nigeria.

ABSTRACT

The burden of cardiovascular diseases has been reported to be on the rise globally and particularly in resource poor low- and middle-income countries. Cardiac rehabilitation is an important secondary prevention programme that has been used to mitigate the burden of cardiovascular diseases. Information on the availability of cardiac rehabilitation in Nigeria has not been previously documented. Therefore, this study was carried out to investigate the availability of cardiac rehabilitation in tertiary hospitals in the northwestern geopolitical zone of Nigeria. A purpose-designed questionnaire with sections on availability, implementation, knowledge, perception and barriers to cardiac rehabilitation was used to obtain data from healthcare professionals (N=245).With a questionnaire return rate of 70%, it was revealed that cardiac rehabilitation was low; only 4.08% of healthcare professionals reporting its availability in three hospitals (Aminu Kano Teaching Hospital, Ahmadu Bello University Teaching Hospital and Federal Medical Centre, Gusau) which offered mainly phase I cardiac rehabilitation that was not based on multidisciplinary approach. Cardiologists, physiotherapists, nurses, dietitians and psychologists were the most commonly involved health professionals in the cardiac rehabilitation offered in the three hospitals. The components of cardiac rehabilitation mostly offered were pharmacological intervention and exercise training, with myocardial infarction (MI) and heart failure being the most commonly managed conditions. Majority (95.9%) of the health professionals implemented the components of cardiac rehabilitation through referral. The highest number of referrals was from family physicians to cardiologists (39.3%), followed by those from family physicians to physiotherapists (17.9%). The study also found no significant association between years of experience and knowledge about cardiac rehabilitation (P>0.05). Also, there was no relationship between years of experience and implementation of cardiac rehabilitation (P>0.05). Unavailability of a comprehensive cardiac rehabilitation programme, inadequate knowledge of same among health professionals and lack of awareness about the complementary role of healthcare professionals in the management of patients with cardiovascular disease were the main barriers to utilisation of the intervention. Majority of the respondents reported unavailability of cardiac rehabilitation, but implemented its individual components in a fragmented fashion such that any one of them might not be fully aware of the complementary roles of the others. It was concluded that although the availability of cardiac rehabilitation in north-western Nigeria was low, there was good perception among healthcare professionals about its importance as a secondary prevention programme. Healthcare personnel involved in the management of cardiovascular diseases, health authorities and other relevant stakeholders should focus on ways to overcome barriers to the utilisation of this important intervention in order to improve its availability and reduce the burden of cardiovascular diseases.