{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:45:42Z","timestamp":1791614742957,"version":"4.3.4"},"reference-count":54,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Qatar University International Research Collaboration Co-Fund"},{"DOI":"10.13039\/501100000105","name":"York University","doi-asserted-by":"publisher","award":["IRCC-2025-648"],"award-info":[{"award-number":["IRCC-2025-648"]}],"id":[{"id":"10.13039\/501100000105","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Faculty Mobility for Partnership Building Program of Global Affairs Canada"},{"DOI":"10.13039\/501100003243","name":"Ministry of Health of the Czech Republic","doi-asserted-by":"publisher","award":["65269705"],"award-info":[{"award-number":["65269705"]}],"id":[{"id":"10.13039\/501100003243","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To characterize global variation in cardiac rehabilitation (CR) staffing, indications, and prescribed dose by country income classification and compare findings with the International Council of Cardiovascular Prevention and Rehabilitation\u2019s 2016 Global Audit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Cross-sectional REDCap survey of Phase II\/post-discharge CR programmes (May\u2013September 2025). Outcomes were multidisciplinary team size\/composition, accepted cardiac and non-cardiac indications, and centre-based CR dose. Comparisons were made across World Bank country income classifications and Audit decade (2016 vs. 2025). Of 7025 programmes identified globally, 1505 (median programme response rate = 62%\/country) initiated a survey, from 90\/113 (80%) countries with CR. CR was delivered by a multidisciplinary team of 7 (median; P25\u2013P75 = 5\u20138; nurses, physiotherapists, cardiologists, and dietitians most common); teams were smaller in low-income countries (median = 4; P &amp;lt; 0.001), and physician specialty varied. Non-low-income programmes consistently accepted (\u226590%) patients with acute coronary syndrome, with programmes in low-income countries less often accepting related interventions (e.g. surgery: low-income 0% vs. high-income 97%; P &amp;lt; 0.01), but non-cardiac indications were more frequently accepted (e.g. primary prevention, diabetes, and lung disease). Acceptance of heart failure increased compared with the previous Audit (70% vs. 87%; P &amp;lt; 0.001). Centre-based programmes prescribed a median of 20\u2005h (P25\u2013P75 = 12\u201330), typically two sessions\/week over 8 weeks. Globally, 65 (72%) countries prescribed a median \u226512 sessions\/programme. Programmes in upper-middle-income countries prescribed more sessions (median = 24, P25\u2013P75 = 12\u201336; P &amp;lt; 0.001). Dose did not differ meaningfully between Audits (P = 0.07).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CR programmes globally are offered by small, but multidisciplinary teams. They accept guideline-indicated patients, with applicable variation by context. Insufficient dose in one-quarter of countries underscores investment need.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag292","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:46:58Z","timestamp":1779968818000},"source":"Crossref","is-referenced-by-count":5,"title":["Staffing, accepted indications, and dose of Phase II cardiac rehabilitation: country income class and time-based comparisons from the International Council of Cardiovascular Prevention and Rehabilitation\u2019s (ICCPR) 2025 Audit Update"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7946-3718","authenticated-orcid":false,"given":"Gabriela L M","family":"Ghisi","sequence":"first","affiliation":[{"name":"KITE Research Institute, University Health Network , Address: 347 Rumsey Road, Toronto, Ontario M4G 1R7 ,","place":["Canada"]},{"name":"Department of Physical Therapy, University of Toronto , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4162-7761","authenticated-orcid":false,"given":"Karam","family":"Turk-Adawi","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Health Science, QU Health, Qatar University , Doha ,","place":["Qatar"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0994-932X","authenticated-orcid":false,"given":"Warner M","family":"Mampuya","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine and Health Sciences, Universit\u00e9 de Sherbrooke , Sherbrooke ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9884-8055","authenticated-orcid":false,"given":"Mariya P","family":"Jiandani","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Seth GS Medical College and KEM Hospital , Mumbai ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2086-4562","authenticated-orcid":false,"given":"Lilian","family":"Mbau","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation, Centre for Cardiovascular Prevention and Rehabilitation , Nairobi ,","place":["Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2319-1150","authenticated-orcid":false,"given":"Monserrat","family":"Cruz Rivero","sequence":"additional","affiliation":[{"name":"Casa Coraz\u00f3n Otoch Puksikal Cardiac Rehabilitation, , M\u00e9rida ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8649-7289","authenticated-orcid":false,"given":"Claudia V","family":"Anchique","sequence":"additional","affiliation":[{"name":"Mediagn\u00f3stica Tecmedi SAS Cardiac Rehabilitation, , Duitama ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rongjing","family":"Ding","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Center, Peking Union Medical College Hospital , Beijing ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinah L","family":"van Schalkwijk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Radboud University Medical Center , Nijmegen ,","place":["The Netherlands"]},{"name":"Department of Medical and Clinical Psychology, Tilburg University , Tilburg ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2342-8013","authenticated-orcid":false,"given":"Jonathan","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Department of Cardiology (Cardiac Rehabilitation), Beaumont Hospital , Dublin ,","place":["Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chamila","family":"Mettananda","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, University of Kelaniya, Faculty of Medicine , Ragama ,","place":["Sri Lanka"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalia","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation, National Cardiovascular Institute\u2014INCOR , Lima ,","place":["Per\u00fa"]},{"name":"San Fernando Medical School, National University of San Marcos , Lima ,","place":["Per\u00fa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4758-9225","authenticated-orcid":false,"given":"Ngone Diaba","family":"Gaye","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation, Ibra Mamadou Wane Medical Center , Dakar ,","place":["Senegal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1199-5707","authenticated-orcid":false,"given":"Won-Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital , Seongnam-si ,","place":["South Korea"]},{"name":"Gyeonggi Regional Cardiocerebrovascular Disease Center, Seoul National University Bundang Hospital , Seongnam-si ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0190-8988","authenticated-orcid":false,"given":"Pamela","family":"Seron","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Sciences, University of La Frontera , Temuco ,","place":["Chile"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8893-374X","authenticated-orcid":false,"given":"Lela","family":"Maskhulia","sequence":"additional","affiliation":[{"name":"Physical Medicine, Tbilisi State Medical University , Tbilisi ,","place":["Georgia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2147-1541","authenticated-orcid":false,"given":"Ladislav","family":"Batalik","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, University Hospital Brno , Brno ,","place":["Czech Republic"]},{"name":"Rehabilitation Clinic, Faculty of Medicine, Masaryk University , Brno ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimena","family":"Martinez","sequence":"additional","affiliation":[{"name":"Instituto M\u00e9dico DAMIC Cardiac Rehabilitation, , C\u00f3rdoba 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Complutense University School of Medicine , Madrid ,","place":["Spain"]},{"name":"Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic , Rochester, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel V Hau","family":"Botha","sequence":"additional","affiliation":[{"name":"Kamuzu Central Hospital Cardiac Rehabilitation, , Lilongwe ,","place":["Malawi"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5901-5619","authenticated-orcid":false,"given":"Jirapa","family":"Champaiboon","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7063-3610","authenticated-orcid":false,"given":"Sherry L","family":"Grace","sequence":"additional","affiliation":[{"name":"Faculty of Health, York University , Toronto ,","place":["Canada"]},{"name":"KITE\u2014Toronto Rehab & Peter Munk Cardiac Centre, University Health Network, University of Toronto , Toronto ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the ICCPR Global Cardiac Rehabilitation Audit Update Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buket","family":"Akinci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael 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