eCite Digital Repository

Challenges in managing acute cardiovascular diseases and follow up care in rural areas: a narrative review


Thompson, SC and Nedkoff, L and Katzenellenbogen, J and Hussain, MA and Sanfilippo, F, Challenges in managing acute cardiovascular diseases and follow up care in rural areas: a narrative review, International Journal of Environmental Research and Public Health, 16 Article 5126. ISSN 1661-7827 (2019) [Refereed Article]


Copyright Statement

Copyright 2019 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

DOI: doi:10.3390/ijerph16245126


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 di erences 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 di erences, 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.

Item Details

Item Type:Refereed Article
Keywords:rural, remote, acute coronary syndrome, revascularization, cardiac rehabilitation, cardiovascular, prevention, workforce, primary care, access, outcomes, review
Research Division:Health Sciences
Research Group:Public health
Research Field:Preventative health care
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Hussain, MA (Dr Akhtar Hussain)
ID Code:136331
Year Published:2019
Web of Science® Times Cited:13
Deposited By:Menzies Institute for Medical Research
Deposited On:2019-12-16
Last Modified:2022-08-25
Downloads:15 View Download Statistics

Repository Staff Only: item control page