Sherry L Grace

Heart disease is among the leading causes of disability globally. It is recommended that heart patients attend cardiac rehabilitation (CR). This is an outpatient chronic disease management program, promoting heart-health behaviour changes such as exercise, diet and tobacco cessation, as well as risk factor management and psychosocial well-being. Participation in CR results in improved quality of life, less re-hospitalization and 25% less death, compared to patients who do not participate. Unfortunately, research demonstrates that only ~30% of patients have access to CR, and this is even lower in women and ethnocultural minorities, among other groups. Rates are even lower in low- and middle-income countries, where there the epidemic of heart disease is at its worst. There are a combination of factors relating to patients (e.g., transportation barriers, work and family obligations), physicians (e.g., failure to refer), and the healthcare system itself (e.g., lack of programs, insufficient resources) that lead to this low CR use.

The objective of Dr. Grace's program of research is to address these barriers to CR participation, so we can reach and treat all heart patients. This has involved, for example, establishing that systematically referring all heart patients to CR in the hospital before they go home, results in 8 times more patients accessing CR. This research formed the basis of a national policy position on CR referral. Another line of study involved the development of a scale to measure CR barriers; this scale is now being used around the world (translated to 15 languages) to identify patient’s barriers, which can then be mitigated to achieve greater CR use. Finally, Professor Grace’s work has also been instrumental in understanding the delivery of CR provincially, nationally and globally, and the impact of this delivery on patient health. For example, she has shown that only half of the countries globally even offer CR, and that CR as delivered in low and middle-income countries also results in improved outcomes for patients. Through her service to major cardiac societies at national and international levels, she works to ensure that gaps in CR care are recognized and addressed.