Patient education and health communication in cardiac rehabilitation in Taiwan: A position statement from the Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation

Cardiac rehabilitation is a comprehensive secondary prevention intervention for patients with cardiovascular disease. In Taiwan, professional consensus statements and National Health Insurance-supported care models have established an important clinical foundation for cardiac and cardiopulmonary rehabilitation after acute myocardial infarction and heart failure. However, real-world participation, adherence, and completion remain suboptimal, suggesting that the effectiveness of cardiac rehabilitation depends not only on referral and exercise prescription, but also on patient education, health communication, shared decision-making, and coordinated care transitions. This Short Communication presents a Taiwan-based position statement under the auspices of the Taiwan Academy of Cardiovascular and Pulmonary Rehabilitation, addressing patient education and health communication as core components of cardiac rehabilitation. We summarize Taiwan-specific evidence from acute myocardial infarction rehabilitation, post-COVID-19 phase II cardiac rehabilitation promotion, heart failure post-acute care, and national heart failure care systems and service models. These data indicate that multidisciplinary team care, early inpatient referral, structured discharge education, case-manager coordination, cardiopulmonary exercise testing, family engagement, and individualized self-management support are essential to improving rehabilitation uptake and outcomes. In Taiwan, barriers to cardiac rehabilitation include limited patient awareness, insufficient physician endorsement, uncoordinated referral processes, transportation and time constraints, uneven distribution of heart failure teams, and limited telemedicine services. We propose that cardiac rehabilitation education in Taiwan should be phase-based, health-literacy sensitive, family-inclusive, and supported by standardized communication pathways. Priority actions include early inpatient education, automatic or opt-out referral systems, strong physician endorsement, case-manager or liaison support, individualized written or digital exercise instructions, shared decision-making tools, and hybrid models for patients with access barriers. Strengthening patient education and health communication is a practical and policy-relevant strategy to improve cardiac rehabilitation referral, enrollment, adherence, and long-term self-management in Taiwan.