Affordable Cardiac Rehabilitation An Outreach Inter-Disciplinary Strategic Study (ACROSS) – Research Programme Protocol

ACROSS Collaborative Group

doi:10.3310/nihropenres.13957.1

Affordable Cardiac Rehabilitation An Outreach Inter-Disciplinary Strategic Study (ACROSS) – Research Programme Protocol

ACROSS Collaborative Group

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

Background: The evidence and infrastructure needed to access and deliver cardiac rehabilitation (CR) services are absent or lacking in low and middle-income countries (LMICs), resulting in a substantial loss of potential health and socio-economic benefits. Home-based programmes provide an affordable model of delivery that can leverage a scalable increase in CR access in LMICs. ACROSS (Affordable Cardiac Rehabilitation: An Outreach Inter-disciplinary Strategic Study) seeks to co-develop (with patients, caregivers, clinicians, and service commissioners) a culturally and contextually applicable and affordable home-based programme for people with the multimorbidity of coronary heart disease and/or heart failure with co-existing depression and/or anxiety and evaluate the acceptability, clinical effectiveness, and cost-effectiveness of its implementation in Bangladesh, India, and Pakistan and to determine its scalability and sustainability. Methods: Four linked work packages (WPs). WP1 (cultural adaptation/refinement of home-based rehabilitation): examine rehabilitation implementation barriers/enablers from multiple stakeholder perspectives and co-develop a feasible and acceptable culturally & contextually adapted home-based programme, extended to take account of co-existing depression and/or anxiety; WP2 (external pilot): assess feasibility/acceptability of the co-developed rehabilitation intervention and study design and processes necessary for a full-scale trial; WP3: (multicentre/multi-country hybrid effectiveness and implementation randomised trial) determine the clinical and cost-effectiveness of a culturally adapted home-based rehabilitation intervention for people with coronary heart disease and/or heart failure and depression and/or anxiety; WP4 (capacity building): build research and rehabilitation delivery capacity. Conclusions: The ACROSS programme overarching goal is to develop a clinically and cost-effective CR model in low-resource settings for people in Bangladesh, India, and Pakistan with a multimorbidity of heart disease and depression and/or anxiety with the potential for substantial health and socio-economic benefits.

Original language	English
Article number	41
Journal	NIHR Open Research
Volume	5
DOIs	https://doi.org/10.3310/nihropenres.13957.1
Publication status	Published - 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

All Science Journal Classification (ASJC) codes

Epidemiology
Medicine (miscellaneous)
Health Policy
Public Health, Environmental and Occupational Health

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10.3310/nihropenres.13957.1

Cite this

@article{adaebd7c61e44cf3a7b836b783f7ef8b,

title = "Affordable Cardiac Rehabilitation An Outreach Inter-Disciplinary Strategic Study (ACROSS) – Research Programme Protocol",

abstract = "Background: The evidence and infrastructure needed to access and deliver cardiac rehabilitation (CR) services are absent or lacking in low and middle-income countries (LMICs), resulting in a substantial loss of potential health and socio-economic benefits. Home-based programmes provide an affordable model of delivery that can leverage a scalable increase in CR access in LMICs. ACROSS (Affordable Cardiac Rehabilitation: An Outreach Inter-disciplinary Strategic Study) seeks to co-develop (with patients, caregivers, clinicians, and service commissioners) a culturally and contextually applicable and affordable home-based programme for people with the multimorbidity of coronary heart disease and/or heart failure with co-existing depression and/or anxiety and evaluate the acceptability, clinical effectiveness, and cost-effectiveness of its implementation in Bangladesh, India, and Pakistan and to determine its scalability and sustainability. Methods: Four linked work packages (WPs). WP1 (cultural adaptation/refinement of home-based rehabilitation): examine rehabilitation implementation barriers/enablers from multiple stakeholder perspectives and co-develop a feasible and acceptable culturally \& contextually adapted home-based programme, extended to take account of co-existing depression and/or anxiety; WP2 (external pilot): assess feasibility/acceptability of the co-developed rehabilitation intervention and study design and processes necessary for a full-scale trial; WP3: (multicentre/multi-country hybrid effectiveness and implementation randomised trial) determine the clinical and cost-effectiveness of a culturally adapted home-based rehabilitation intervention for people with coronary heart disease and/or heart failure and depression and/or anxiety; WP4 (capacity building): build research and rehabilitation delivery capacity. Conclusions: The ACROSS programme overarching goal is to develop a clinically and cost-effective CR model in low-resource settings for people in Bangladesh, India, and Pakistan with a multimorbidity of heart disease and depression and/or anxiety with the potential for substantial health and socio-economic benefits.",

author = "\{ACROSS Collaborative Group\} and Taylor, \{Rod S.\} and Chaudhry, \{Imran Bashir\} and Mithila Faraque and Panniyammakal Jeemon and Amy Blakemore and Karina Lovell and Nusrat Husain and Tahir Saghir and Mashreky, \{Saidur Rahman\} and Sivadasanpillai Harikrishnan and Ahmed, \{Chaudhury Meshkat\} and \{Samuel Babu\}, Abraham and Alex McConnachie and Emma McIntosh and Rakhshi Memon and Sally Singh and Alastair Leyland and Bhautesh Jani and Walter Flores and Rezaul Karim and \{Ul Haq\}, Zia and Nabila Soomro and Zadeh, \{Zainab B.\} and Ameer Khoso and Sehrish Tofique and Farhat Jafri and Riffat Sultana and Huma Naeem and \{Chandra Banik\}, Palash and Sohel Choudhury and Louise Taylor and Jamal Uddin and Claire Copping and David Innes and \{Roy TN\}, Sunil and Stigi Joseph and Vijayan Ganesan and Prabhu, \{Mukund A.\} and \{Vijay MS\}, Jyothi and \{Das NK\}, Ramya",

note = "Publisher Copyright: Copyright: {\textcopyright} 2025 Taylor RS et al.",

year = "2025",

doi = "10.3310/nihropenres.13957.1",

language = "English",

volume = "5",

journal = "NIHR Open Research",

issn = "2633-4402",

publisher = "F1000 Research Ltd",

}

TY - JOUR

T1 - Affordable Cardiac Rehabilitation An Outreach Inter-Disciplinary Strategic Study (ACROSS) – Research Programme Protocol

AU - ACROSS Collaborative Group

AU - Taylor, Rod S.

AU - Chaudhry, Imran Bashir

AU - Faraque, Mithila

AU - Jeemon, Panniyammakal

AU - Blakemore, Amy

AU - Lovell, Karina

AU - Husain, Nusrat

AU - Saghir, Tahir

AU - Mashreky, Saidur Rahman

AU - Harikrishnan, Sivadasanpillai

AU - Ahmed, Chaudhury Meshkat

AU - Samuel Babu, Abraham

AU - McConnachie, Alex

AU - McIntosh, Emma

AU - Memon, Rakhshi

AU - Singh, Sally

AU - Leyland, Alastair

AU - Jani, Bhautesh

AU - Flores, Walter

AU - Karim, Rezaul

AU - Ul Haq, Zia

AU - Soomro, Nabila

AU - Zadeh, Zainab B.

AU - Khoso, Ameer

AU - Tofique, Sehrish

AU - Jafri, Farhat

AU - Sultana, Riffat

AU - Naeem, Huma

AU - Chandra Banik, Palash

AU - Choudhury, Sohel

AU - Taylor, Louise

AU - Uddin, Jamal

AU - Copping, Claire

AU - Innes, David

AU - Roy TN, Sunil

AU - Joseph, Stigi

AU - Ganesan, Vijayan

AU - Prabhu, Mukund A.

AU - Vijay MS, Jyothi

AU - Das NK, Ramya

PY - 2025

Y1 - 2025

N2 - Background: The evidence and infrastructure needed to access and deliver cardiac rehabilitation (CR) services are absent or lacking in low and middle-income countries (LMICs), resulting in a substantial loss of potential health and socio-economic benefits. Home-based programmes provide an affordable model of delivery that can leverage a scalable increase in CR access in LMICs. ACROSS (Affordable Cardiac Rehabilitation: An Outreach Inter-disciplinary Strategic Study) seeks to co-develop (with patients, caregivers, clinicians, and service commissioners) a culturally and contextually applicable and affordable home-based programme for people with the multimorbidity of coronary heart disease and/or heart failure with co-existing depression and/or anxiety and evaluate the acceptability, clinical effectiveness, and cost-effectiveness of its implementation in Bangladesh, India, and Pakistan and to determine its scalability and sustainability. Methods: Four linked work packages (WPs). WP1 (cultural adaptation/refinement of home-based rehabilitation): examine rehabilitation implementation barriers/enablers from multiple stakeholder perspectives and co-develop a feasible and acceptable culturally & contextually adapted home-based programme, extended to take account of co-existing depression and/or anxiety; WP2 (external pilot): assess feasibility/acceptability of the co-developed rehabilitation intervention and study design and processes necessary for a full-scale trial; WP3: (multicentre/multi-country hybrid effectiveness and implementation randomised trial) determine the clinical and cost-effectiveness of a culturally adapted home-based rehabilitation intervention for people with coronary heart disease and/or heart failure and depression and/or anxiety; WP4 (capacity building): build research and rehabilitation delivery capacity. Conclusions: The ACROSS programme overarching goal is to develop a clinically and cost-effective CR model in low-resource settings for people in Bangladesh, India, and Pakistan with a multimorbidity of heart disease and depression and/or anxiety with the potential for substantial health and socio-economic benefits.

AB - Background: The evidence and infrastructure needed to access and deliver cardiac rehabilitation (CR) services are absent or lacking in low and middle-income countries (LMICs), resulting in a substantial loss of potential health and socio-economic benefits. Home-based programmes provide an affordable model of delivery that can leverage a scalable increase in CR access in LMICs. ACROSS (Affordable Cardiac Rehabilitation: An Outreach Inter-disciplinary Strategic Study) seeks to co-develop (with patients, caregivers, clinicians, and service commissioners) a culturally and contextually applicable and affordable home-based programme for people with the multimorbidity of coronary heart disease and/or heart failure with co-existing depression and/or anxiety and evaluate the acceptability, clinical effectiveness, and cost-effectiveness of its implementation in Bangladesh, India, and Pakistan and to determine its scalability and sustainability. Methods: Four linked work packages (WPs). WP1 (cultural adaptation/refinement of home-based rehabilitation): examine rehabilitation implementation barriers/enablers from multiple stakeholder perspectives and co-develop a feasible and acceptable culturally & contextually adapted home-based programme, extended to take account of co-existing depression and/or anxiety; WP2 (external pilot): assess feasibility/acceptability of the co-developed rehabilitation intervention and study design and processes necessary for a full-scale trial; WP3: (multicentre/multi-country hybrid effectiveness and implementation randomised trial) determine the clinical and cost-effectiveness of a culturally adapted home-based rehabilitation intervention for people with coronary heart disease and/or heart failure and depression and/or anxiety; WP4 (capacity building): build research and rehabilitation delivery capacity. Conclusions: The ACROSS programme overarching goal is to develop a clinically and cost-effective CR model in low-resource settings for people in Bangladesh, India, and Pakistan with a multimorbidity of heart disease and depression and/or anxiety with the potential for substantial health and socio-economic benefits.

UR - https://www.scopus.com/pages/publications/105029431415

UR - https://www.scopus.com/pages/publications/105029431415#tab=citedBy

U2 - 10.3310/nihropenres.13957.1

DO - 10.3310/nihropenres.13957.1

M3 - Article

AN - SCOPUS:105029431415

SN - 2633-4402

VL - 5

JO - NIHR Open Research

JF - NIHR Open Research

M1 - 41

ER -

Affordable Cardiac Rehabilitation An Outreach Inter-Disciplinary Strategic Study (ACROSS) – Research Programme Protocol

Abstract

UN SDGs

All Science Journal Classification (ASJC) codes

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