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Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review

Author

Listed:
  • Sandra C. Thompson

    (Western Australian Centre for Rural Health, The University of Western Australia, P.O. Box 109, Geraldton 6531, Australia)

  • Lee Nedkoff

    (School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Highway, Perth 6009, Australia)

  • Judith Katzenellenbogen

    (School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Highway, Perth 6009, Australia)

  • Mohammad Akhtar Hussain

    (Western Australian Centre for Rural Health, The University of Western Australia, P.O. Box 109, Geraldton 6531, Australia
    Menzies Institute for Medical Research, University of Tasmania, 15-17 Liverpool Street, Hobart, Tasmania 7000, Australia)

  • Frank Sanfilippo

    (School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Highway, Perth 6009, Australia)

Abstract

This narrative review explores relevant literature that is related to the challenges in implementing evidence-based management for clinicians in rural and remote areas, while primarily focussing on management of acute coronary syndrome (ACS) and follow up care. A targeted literature search around rural/urban differences in the management of ACS, cardiovascular disease, and cardiac rehabilitation identified multiple issues that are related to access, including the ability to pay, transport and geographic distances, delays in patients seeking care, access to diagnostic testing, and timely treatment in an appropriate facility. Workforce shortages or lack of ready access to relevant expertise, cultural differences, and complexity that arises from comorbidities and from geographical isolation amplified diagnostic challenges. Given the urgency in management of ACS, rural clinicians must act quickly to achieve optimal patient outcomes. New technologies and quality improvement approaches enable better access to rapid diagnosis, as well as specialist input and care. Achieving an uptake of cardiac rehabilitation in rural and remote settings poses challenges that may reduce with the use of alternative models to centre-based rehabilitation and use of modern technologies. Expediting improvement in cardiovascular outcomes and reducing rural disparities requires system changes and that clinicians embrace attention to prevention, emergency management, and follow up care in rural contexts.

Suggested Citation

  • Sandra C. Thompson & Lee Nedkoff & Judith Katzenellenbogen & Mohammad Akhtar Hussain & Frank Sanfilippo, 2019. "Challenges in Managing Acute Cardiovascular Diseases and Follow Up Care in Rural Areas: A Narrative Review," IJERPH, MDPI, vol. 16(24), pages 1-17, December.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:24:p:5126-:d:298241
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    References listed on IDEAS

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    1. Taylor, H.A. & Hughes, G.D. & Garrison, R.J., 2002. "Cardiovascular disease among women residing in rural America: Epidemiology, explanations, and challenges," American Journal of Public Health, American Public Health Association, vol. 92(4), pages 548-551.
    2. Edward Griffin & Graham Moon & Ross Barnet, 2015. "Examining the significance of urban–rural context in tobacco quitline use: does rurality matter?," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(3), pages 327-333, March.
    3. Stella C. E. Anyangwe & Chipayeni Mtonga, 2007. "Inequities in the Global Health Workforce: The Greatest Impediment to Health in Sub-Saharan Africa," IJERPH, MDPI, vol. 4(2), pages 1-8, June.
    4. Mohammad Akhtar Hussain & Judith M Katzenellenbogen & Frank M Sanfilippo & Kevin Murray & Sandra C Thompson, 2018. "Complexity in disease management: A linked data analysis of multimorbidity in Aboriginal and non-Aboriginal patients hospitalised with atherothrombotic disease in Western Australia," PLOS ONE, Public Library of Science, vol. 13(8), pages 1-18, August.
    5. Eberhardt, M.S. & Pamuk, E.R., 2004. "The importance of place of residence: Examining health in rural and nonrural areas," American Journal of Public Health, American Public Health Association, vol. 94(10), pages 1682-1686.
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    Cited by:

    1. Mamoeng Nancy Kgatla & Tebogo M. Mothiba & Tholene Sodi & Mpsanyana Makgahlela, 2021. "Nurses’ Experiences in Managing Cardiovascular Disease in Selected Rural and Peri-Urban Clinics in Limpopo Province, South Africa," IJERPH, MDPI, vol. 18(5), pages 1-12, March.
    2. Daniele Melo Sardinha & Alzinei Simor & Letícia Diogo de Oliveira Moura & Ana Gracinda Ignácio da Silva & Karla Valéria Batista Lima & Juliana Conceição Dias Garcez & Lidiane Assunção de Vasconcelos &, 2020. "Risk Factors for Acute Renal Failure after Cardiac Catheterization Most Cited in the Literature: An Integrative Review," IJERPH, MDPI, vol. 17(10), pages 1-13, May.

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