{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:50:29Z","timestamp":1791856229943,"version":"4.3.4"},"reference-count":17,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T00:00:00Z","timestamp":1789776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,11,5]]},"abstract":"<jats:p>Cardiac rehabilitation (CR) is an evidence-based secondary prevention intervention associated with reduced cardiovascular mortality and hospital readmissions and improved quality of life. Despite strong guideline recommendations, participation remains low in Australia and internationally, particularly among rural and remote populations, Aboriginal and Torres Strait Islander peoples and other underserved populations. This reflects a service delivery challenge rather than an evidence gap. Current CR models remain largely centred on metropolitan hospital-based programs that may not adequately meet the needs of geographically dispersed populations. This policy reflection argues that improving CR participation requires a shift towards more accessible and integrated models of care, including automatic referral pathways, telehealth and hybrid delivery models, stronger primary care involvement and partnerships with Aboriginal Community Controlled Health Organisations. Improving access to CR should be viewed as a broader health system priority with important implications for healthcare equity, chronic disease management and cardiovascular outcomes.<\/jats:p>","DOI":"10.1071\/ah26122","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:41:51Z","timestamp":1791855711000},"source":"Crossref","is-referenced-by-count":0,"title":["Improving access to cardiac rehabilitation in Australia: a policy reflection on equitable secondary prevention"],"prefix":"10.1071","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-7975-4254","authenticated-orcid":true,"given":"Sampathawaduge Ashail","family":"Silva","sequence":"first","affiliation":[{"name":"Department of Cardiology A , , , , .","place":["Traralgon, Vic 3842, Australia"]},{"name":"Latrobe Regional Health A , , , , .","place":["Traralgon, Vic 3842, Australia"]},{"name":"Department of Medicine B , , , , .","place":["Traralgon, Vic 3842, Australia"]},{"name":"Latrobe Regional Health B , , , , .","place":["Traralgon, Vic 3842, Australia"]},{"name":"Monash Rural Health C , , , , .","place":["Gippsland, Vic 3842, Australia"]},{"name":"Faculty of Medicine, Nursing and Health Sciences, Monash University C , , , , .","place":["Gippsland, Vic 3842, Australia"]},{"name":"Department of Medicine D , , , , .","place":["Darwin, NT 0810, Australia"]},{"name":"Royal Darwin Hospital D , , , , .","place":["Darwin, NT 0810, Australia"]},{"name":"Department of Cardiology E , , , , .","place":["Darwin, NT 0810, Australia"]},{"name":"Royal Darwin Hospital E , , , , .","place":["Darwin, NT 0810, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenelie","family":"Silva","sequence":"additional","affiliation":[{"name":"Faculty of Medicine F , , , , .","place":["Rathmalana, WP, Sri Lanka"]},{"name":"General Sir John Kotelawala Defence University F , , , , .","place":["Rathmalana, WP, Sri Lanka"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binita","family":"Duwadi","sequence":"additional","affiliation":[{"name":"Department of Medicine D , , , , .","place":["Darwin, NT 0810, Australia"]},{"name":"Royal Darwin Hospital D , , , , .","place":["Darwin, NT 0810, Australia"]},{"name":"Department of Cardiology E , , , , .","place":["Darwin, NT 0810, Australia"]},{"name":"Royal Darwin Hospital E , , , , .","place":["Darwin, NT 0810, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ee Kit","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Medicine B , , , , .","place":["Traralgon, Vic 3842, Australia"]},{"name":"Latrobe Regional Health B , , , , .","place":["Traralgon, Vic 3842, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"2026101221414592700_R1"},{"issue":"1","key":"2026101221414592700_R2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis.","volume":"67","author":"Anderson","year":"2016","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"2026101221414592700_R3","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001800.pub3","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease.","volume":"2016","author":"Anderson","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"12","key":"2026101221414592700_R4","doi-asserted-by":"publisher","first-page":"683","DOI":"10.5694\/j.1326-5377.2009.tb02636.x","article-title":"An integrated and coordinated approach to preventing recurrent coronary heart disease events in Australia.","volume":"190","author":"Briffa","year":"2009","journal-title":"Med J Aust"},{"key":"2026101221414592700_R5"},{"key":"2026101221414592700_R6","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-016-0330-3","article-title":"Cardiac rehabilitation for Aboriginal and Torres Strait Islander people in Western Australia.","volume":"16","author":"Hamilton","year":"2016","journal-title":"BMC Cardiovasc Disord"},{"issue":"8","key":"2026101221414592700_R7","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1089\/jwh.2016.6249","article-title":"Barriers for nonparticipation and dropout of women in cardiac rehabilitation programs: a systematic review.","volume":"26","author":"Resurrecci\u00f3n","year":"2017","journal-title":"J Womens Health"},{"key":"2026101221414592700_R8"},{"key":"2026101221414592700_R9","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.eclinm.2019.06.007","article-title":"Cardiac rehabilitation availability and density around the globe.","volume":"13","author":"Turk-Adawi","year":"2019","journal-title":"EClinicalMedicine"},{"issue":"15","key":"2026101221414592700_R10","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1161\/CIRCULATIONAHA.107.701466","article-title":"Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery.","volume":"116","author":"Suaya","year":"2007","journal-title":"Circulation"},{"issue":"5","key":"2026101221414592700_R11","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1097\/HJR.0b013e328305df05","article-title":"Contribution of patient and physician factors to cardiac rehabilitation enrollment: a prospective multilevel study.","volume":"15","author":"Grace","year":"2008","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"issue":"3","key":"2026101221414592700_R12","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1001\/archinternmed.2010.501","article-title":"Effect of cardiac rehabilitation referral strategies on utilization rates: a prospective, controlled study.","volume":"171","author":"Grace","year":"2011","journal-title":"Arch Intern Med"},{"key":"2026101221414592700_R13"},{"key":"2026101221414592700_R14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b5631","article-title":"Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis.","volume":"340","author":"Dalal","year":"2010","journal-title":"BMJ"},{"issue":"1","key":"2026101221414592700_R15","doi-asserted-by":"publisher","first-page":"e69","DOI":"10.1161\/CIR.0000000000000663","article-title":"Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology.","volume":"140","author":"Thomas","year":"2019","journal-title":"Circulation"},{"issue":"11","key":"2026101221414592700_R16","doi-asserted-by":"publisher","first-page":"649","DOI":"10.5694\/mja13.00005","article-title":"Aboriginal community controlled health services: leading the way in primary care.","volume":"200","author":"Panaretto","year":"2014","journal-title":"Med J Aust"},{"issue":"15","key":"2026101221414592700_R17","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1136\/heartjnl-2015-308966","article-title":"Telehealth exercise-based cardiac rehabilitation: a systematic review and meta-analysis.","volume":"102","author":"Rawstorn","year":"2016","journal-title":"Heart"}],"container-title":["Australian Health Review"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/ah\/article-pdf\/doi\/10.1071\/AH26122\/1973408\/ah26122.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/ah\/article-pdf\/doi\/10.1071\/AH26122\/1973408\/ah26122.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:41:51Z","timestamp":1791855711000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/ah\/article\/50\/5\/AH26122\/276256\/Improving-access-to-cardiac-rehabilitation-in"}},"subtitle":[],"editor":[{"given":"Robert","family":"Borotkanics","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,10,13]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,11,5]]}},"URL":"https:\/\/doi.org\/10.1071\/ah26122","relation":{},"ISSN":["0156-5788","1449-8944"],"issn-type":[{"value":"0156-5788","type":"print"},{"value":"1449-8944","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,13]]},"article-number":"AH26122"}}