New CHAP project to support country heart patients

Heart disease is a leading cause of death and illness around the world, with contemporary cardiac rehabilitation vital to ensure a return to better health and to prevent disease reoccurrence. However, as many as 50% of heart patients do not get a referral to complete or continue with a recommended cardiac rehab program.

To tackle this challenge, Flinders University has led the development and upgraded launch this month of a comprehensive suite of the latest cardiac rehabilitation information and resources online to support patients in rural and remote areas of South Australia and the Northern Territory.

The Country Health Attack Prevention program, or CHAP Project, is tailor-made for country people’s recovery and secondary prevention support.

The CHAP program leader, Matthew Flinders Professor Robyn Clark, said education about risk management and reduction, exercise, diet, medications and other practical information is not available free for survivors of acute coronary syndrome, stable angina, coronary artery bypass surgery, heart failure and percutaneous coronary interventions.

“This program aims to offer flexible, interactive, web-based information for patients to keep up their rehabilitation,” Clark said.

With about 18 million deaths a year globally, it’s estimated that one Australian suffers a fatal cardiovascular event every 12 minutes — equating to about one-quarter of all deaths. Australians living in rural and remote areas have up to 90% higher rates of cardiovascular disease (CVD) related hospitalisation and 60% higher rates of CVD death than those in metropolitan areas (ABS 2020, AIHW 2018).

Project researcher Katie Nesbitt said the CHAP Project team worked extensively with country patients to develop the web-based program with the right kind of evidence-based resources to suit men and women of all ages.

She said the progressive rollout has been successful, with the latest version going online earlier this month (July 2023) after working with the Integrated Clinical Cardiovascular Network via its Country Access to Cardiac Health program, which provides telephone or face-to-face programs for eligible patients.

“Importantly, this program will now have a self-enrolment function from hospital discharge, providing patients with a remote standalone or bridging program until they start a face-to-face or telephone service,” said Nesbitt, also from Flinders University’s Caring Futures Institute in the College of Nursing and Health Sciences.

“This means patients can access their cardiac rehabilitation education early and autonomously and country patients can do web or telephone or combination, with those eligible for face-to-face needing to live within 50 km of that service.” 

CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebrovascular disease, rheumatic heart disease and other conditions such as heart failure and arrhythmias (WHO 2021).

Partners in the project include the Department for Health and Wellbeing, SA Health, Country Health SA, Country SA Primary Health Network, the Heart Foundation, AstraZeneca, Novartis, the Flinders Foundation, Cardiac Society of Australia and New Zealand (CSANZ), the Royal Australian College of General Practice (RACGP),  Australian Cardiac Rehabilitation Association, Exercise Scientists Society of Australia and Flinders University.

The CHAP Project was funded by a $3.3 million National Health and Medical Research Partnership grant.

Image caption: CHAP program leader and Matthew Flinders Professor Robyn Clark.