PHA, allies push for full coverage of cardiac rehabilitation in Philhealth Z Package

THE Philippine Heart Association (PHA) and its health allies recently lobbied for full and expanded inclusion of cardiac rehabilitation in the Philhealth Z package, and the increase in accessibility of cardiac rehab in cardiovascular and tertiary care programs nationwide.

The experts also asked the health maintenance organizations to give wider coverage of the cost of cardiac rehab program.

The call was made during the monthly virtual PHA Usapang Puso sa Puso (UPP) Forum on Cardiac Rehab Special themed: “My Enero Heart. My Heart Promise” on Jan. 26, 2022.

This month’s edition was anchored by Dr. Richard Henry Tiongco II, PHA Advocacy chair and Dr. Luigi Pierre Segundo, cochair of the PHA Communications Committee. Tiongco and Segundo, a practicing cardiologist-interventionalist and a cardiologist-electrophysiologist, respectively, were joined by Dr. Benjamin Quito, chair of the PHA Council on Rehabilitation, Dr. Lucky Cuenza, a sports cardiologist; Arthur King, a physical therapist from the Philippine Heart Center and Wilma Bastillo, a cardiac rehab nurse from The Medical City. UPP’S mainstays are media people and netizens.

Cardiac rehab is a structured program that is composed of a team that prescribes and carries out not only progressive and tailored physical activities for such patients with heart failure or after a heart attack, but also includes counselling on mental health, and the adoption of the proper diet and smoking cessation.

The group stressed that after a heart attack, cardiac rehab starts the road to recuperation and revitalization. The vulnerable populations are recommended to undergo cardiac rehabilitation because it significantly speeds up recovery, improves quality of life and reduces mortality.

A Cardiac Rehab team includes doctors, nurses, exercise specialists, physical and occupational therapists, dietitians and mental health specialists. Such a program hence wholistically provides short- and long-term effects that helps recover as much physical and mental health, rebuilds confidence and self-esteem; and guides the patient in adopting heart-healthy habits.

“Compliance rate is only from 10 to 15 percent among heart attack and heart failure patients in the Philippines. Cost, accessibility, poor awareness of people, and even the pandemic have been identified as a major challenges to cardiac rehab,” according to Quito, a cardiologist-cardiac rehab expert.

“Currently, Philhealth subsidy is limited to the patient’s days of confinement at the hospital. The rest of the remaining thrice-aweek-sessions of the three-month program are likely covered by the patient’s account. Such expenses likewise can be challenging even for the average Filipino” who may end up requiring cardiac rehabilitation, Tiongco said.

Citing the Philippine Statistics Authority (PSA) 2021 report, he said that “heart disease ranked number one in the Top 5 leading causes of death in the Philippines for 2019 and 2020.” Heart attack and heart failure have been a growing cardiovascular burden worldwide and in the Philippines. The PSA report showed that from January to September 2021, coronary artery disease sometimes called coronary heart disease or ishaemic heart diseases were the leading cause of death with 91,152 cases or 18.5 percent of the total deaths in the country. This indicated an upswell of about 18.7 percent from the 76,783 mortality rate or 16.9 percent of the total deaths in the same period of 2020.

The group also added that there are only 22 hospitals in the country that have a Cardiac Rehab Unit which are mostly located in the heart of Metro Manila.

Nurse Bastillo said that cardiac telerehab encourages outpatients to continue with their exercises, as a stop-gap solution to bridge and continue cardiac rehab for the appropriate patients.

“PT King said that “the Cardiac Rehab Unit’s team (the PT, nurse and doctors) is in full force during each virtual session via Zoom However, tele-rehab has its limitations. “May taong angkop o tugma para dito” (It’s on a case-to-case basis, thus not all patients can avail of tele-rehab),” Quito said.