Developing Cardiac
Rehabilitation in Vietnam
Dr Juliette Hussey
School of Medicine
Trinity College Dublin
Ireland
Content
Data outlining need for Cardiac Rehabilitation in
Vietnam
Collaboration to date
How a university can change the world- in
relation to cardiac rehabilitation
VIETNAM
Population of Vietnam: 86,206,000
Population of : Ho Chi Minh City (Saigon):
7,123,340; Hanoi 6, 452,000
Country: 331,690 sq km
Cardiovascular disease in LMICs and
Vietnam
Cardiovascular diseases and their risk factors emerging as the
leading cause of morbidity and mortality in developing countries
including Vietnam
Double burden of disease- common communicable diseases
and emerging non-communicable disease during early stages of
health transition
Need for cardiac rehabilitation in LMICs
Globally CVD accounts for 29.2% of deaths and 80% of these in
LMICs
Rapid increase in cardiovascular and non-communicable
diseases
Primary and secondary prevention required
Need for cardiac rehabilitation in
Vietnam
Ischaemic heart disease and cerebrovascular disease- 13% and
11% of all cause mortality in Vietnam
Extent of risk factors unknown- but indications they are rising
Success in management of chronic diseases depends on long
term adherence to treatment, risk factor modification and
lifestyle changes. Key to reducing deaths is to modify risk
through prevention strategies targeting cardiovascular risk
factors
Tabacco related diseases
40 000 people in Vietnam die each year due to smoking (WHO)
One of the highest male smoking rates worldwide
Over half of adult men smoke
Chronic disease in Vietnam
Country experiencing rapid transition and increased burden of
chronic disease
Poorer people more vulnerable to chronic diseases and their risk
factors ( other than overweight)
We know the causes of cardiovascular disease but need to
understand the cause of the causes
Chronic diseases shown to cause economic loss for families
Health care system
Hospitals- overcrowded
Very basic nursing- families provide majority of care
In case of cardiology rapid advances in interventions and
surgery
Need to develop primary care, health promotion and
rehabilitation services
Definitions of Cardiac Rehabilitation
2000
Scottish Intercollegiate
Guideline 57 states
Guidelines
Network
(SIGN)
“Cardiac rehabilitation is the process by which patients with
cardiac disease, in partnership with a multidisciplinary team
of health professionals, are encouraged and supported to
achieve and maintain optimal physical and psychosocial
health”
(SIGN)
SIGN.
Guideline
57
Cardiac
Rehabilitation.
www.sign.ac.uk/guidelines/fulltext/57/section1.html.
Available
at:
Principles of Cardiac Rehabilitation
Behaviour change
Smoking
Exercise
Weight management
Nutrition
Lipids
Blood pressure
Psychosocial factors
Developing cardiac rehabilitation in
Vietnam- aims
To provide initial education, training and practical assistance
for the development of Cardiac Rehabilitation services which
will act as reference centres for the development of services in
surrounding provinces
To facilitate a sustainable education and training programme
for the expansion and delivery of cardiac rehabilitation
services
Strengths from TCD
Considerable experience academically and clinically in the area
of exercise in prevention and treatment of disease
MSc in Cardiac Rehabilitation and Prevention since 2002approx 45 students supervised to date
Now translating much of this experience into the rehabilitation of
patients with other chronic diseases- pulmonary disease and
cancer
Collaboration to date
ASEAN Cardiology conference in 2008 held in Hanoi and one
session on cardiac rehabilitation
Two day introductory course in Ho Chi Minh in 2010
Undergraduate physiotherapy students on elective placement
Have identified and agreed a number of steps necessary but
need funding
Two day introductory course to cardiologists, cardiac
nurses, rehabilitation physicians and physiotherapists
Participants from Ho Chi Minh
How can a University change the World?case of developing cardiac rehabilitation
Collective experience which can be very broad
Knowledge
Analytical skills
In the case of Health Sciences- built on clinical and professional
experience and large network of colleagues nationally and
internationally
Experience in interdisciplinary working
Acknowledgements
HRB/Irish Aid – Networking grant
Bachmai Hospital and Vietnam Heart Institute in Hanoi
Cho ray and An Binh Hospitals in Ho Chi Minh City