Cardiac rehabilitation using telemedicine: the need for tele cardiac rehabilitation

Thamman, Ritu; Janardhanan, Rajesh

doi:10.31083/j.rcm.2020.04.201

Cited by 19 publications

(8 citation statements)

References 22 publications

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“… 46 - 51 On the other hand, the disadvantage of telehealth CR is the lack of social contact and fewer face-to-face interactions associated with the group approach of CBCR. 8 , 16 , 52 The expanding CVD base represented by different patient subgroups requires the inclusion of diverse CR models to optimize health outcomes. Elderly patients have been found to prefer home-based interventions over centrally-based ones.…”

Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

Baťalík

Filáková

Sladeckova

et al. 2023

Eur J Phys Rehabil Med

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INTRODUCTION Alternatives such as remotely delivered therapy in the home environment or telehealth represent an opportunity to increase overall cardiac rehabilitation (CR) utilization. Implementing alternatives into regular practice is the next step in development; however, the cost aspect is essential for policymakers. Limited economic budgets lead to cost-effectiveness analyses before implementation. They are appropriate in cases where there is evidence that the compared intervention provides a similar health benefit to usual care. This systematic review aimed to compare the cost-effectiveness of exercise-based telehealth CR interventions compared to standard exercise-based CR. EVIDENCE ACQUISITION PubMed and Web of Science databases were systematically searched up to August 2022 to identify randomized controlled trials assessing patients undergoing telehealth CR. The intervention was compared to standard CR protocols. The primary intent was to identify the cost-effectiveness. Interventions that met the criteria were home-based telehealth CR interventions delivered by information and communications technology (telephone, computer, internet, or videoconferencing) and included the results of an economic evaluation, comparing interventions in terms of cost-effectiveness, utility, costs and benefits, or cost-minimization analysis. The systematic review protocol was registered in the PROSPERO Registry (CRD42022322531). EVIDENCE SYNTHESIS Out of 1525 identified studies, 67 articles were assessed for eligibility, and, at the end of the screening process, 12 studies were included in the present systematic review. Most studies (92%) included in this systematic review found strong evidence that exercise-based telehealth CR is cost-effective. Compared to CBCR, there were no major differences, except for three studies evaluating a significant difference in average cost per patient and intervention costs in favor of telehealth CR. CONCLUSIONS Telehealth CR based on exercise is as cost-effective as CBCR interventions. Funding telehealth CR by third-party payers may promote patient participation to increase overall CR utilization. High-quality research is needed to identify the most cost-effective design.

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Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

Baťalík

Filáková

Sladeckova

et al. 2023

Eur J Phys Rehabil Med

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show abstract

“…Limitations in patient monitoring, and even in the care that is delivered in remote-based programs, are also key concerns. However, remote-based CR is rapidly evolving, especially in since COVID-19 limited the use of on-site programs [ 27 , 28 ], with the hope that safety, connectedness, and quality of care can all be optimized with advancing technology and experience [ 29 ].…”

Section: Cr Continued Challenges/improving Poor Utilizationmentioning

confidence: 99%

Cardiac Rehabilitation and Survival for Ischemic Heart Disease

Lolley

Forman

2021

Curr Cardiol Rep

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“…HCTR can provide effective monitoring of the physical training of CVD patients, thereby promoting long-term adherence to therapy and reducing the risk of viral transmission. This approach has been shown to be safe, effective, and widely accepted by CVD patients, making it a promising tool in the ongoing fight against cardiovascular disease [ 34 , 35 ]. Exercise therapy remains a cornerstone of cardiac rehabilitation for patients with CVD.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Hybrid Comprehensive Telerehabilitation (HCTR) for Cardiac Rehabilitation in Patients with Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Yang,

Jia,

et al. 2023

Occupational Therapy International

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Backgrounds. Cardiovascular disease (CVD) is a serious condition that poses threats to patients’ quality of life and life expectancy. Cardiac rehabilitation is a crucial treatment option that can improve outcomes for CVD patients. Hybrid comprehensive telerehabilitation (HCTR) is a relatively new approach. In the context of pandemics, HCTR can minimize the risk of cluster infections by reducing hospital visits while delivering effective rehabilitation care. This study is aimed at assessing the efficacy and safety of HCTR as a secondary prevention measure for CVD patients compared to usual rehabilitation care. Methods. We searched PubMed, Embase, The Web of Science, The Cochrane Library, and PsychINFO for all related studies up to January 20, 2023. Two reviewers independently screened the titles and abstracts of potentially eligible articles based on the predefined search criteria. Data were analyzed using a comprehensive meta-analysis software (RevMan5.3). Results. Eight trials, involving 1578 participants, were included. HCTR and usual rehabilitation care provide similar effects on readmission rates (odds ratio OR = 0.90 (95% CI 0.69-1.17), P = 0.43 ) and mortality (odds ratio OR = 1.06 (95% CI 0.72-1.57), P = 0.76 ). Effects on Short Form-36 Health Status Questionnaire (SF-36) score were also similar (SMD: 1.32 (95% CI-0.48-3.11), P = 0.15 ). Compared with usual rehabilitation care, HCTR can improve peak oxygen uptake (VO2 peak) (SMD: 0.99 (95% CI 0.23-1.74), P = 0.01 ) and 6-minute walking test (6MWT) (SMD: 10.02 (95% CI 5.44-14.60), P < 0.001 ) of patients. Conclusions. Our findings indicate that HCTR is as effective as traditional rehabilitation care in reducing readmission rates and mortality and improving quality of life in patients with CVD. However, HCTR offers the added advantage of improving VO2 peak and 6MWT, measurements of cardiorespiratory fitness and functional capacity, respectively. These results suggest that HCTR can be a safe and effective alternative to traditional rehabilitation care, offering numerous benefits for CVD patients. Clinical Study Registration Number. This trial is registered with NCT02523560 and NCT02796404.

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Cardiac rehabilitation using telemedicine: the need for tele cardiac rehabilitation

Cited by 19 publications

References 22 publications

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

Cardiac Rehabilitation and Survival for Ischemic Heart Disease

Efficacy and Safety of Hybrid Comprehensive Telerehabilitation (HCTR) for Cardiac Rehabilitation in Patients with Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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