Cost-utility analysis of home-based cardiac rehabilitation as compared to usual post-discharge care: systematic review and meta-analysis of randomized controlled trials

Bakhshayesh, Samaneh; Hoseini, Benyamin; Bergquist, Robert; Nabovati, Ehsan; Gholoobi, Arash; MohammadEbrahimi, Shahab; Eslami, Saeid

doi:10.1080/14779072.2020.1819239

Cited by 15 publications

(9 citation statements)

References 93 publications

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“…2 b, CVD was unaccompanied with any other co-morbidity in nearly 15% of those who died in Mashhad, which indicates that CVD is a serious condition that potentially can lead to the poor prognosis of COVID-19 [ 50 , 51 ]. The suggestion that can be made considering this high risk for CVD patients is the use of tele-rehabilitation, which has been well proven in previous studies [ 52 , 53 ]. In agreement with our results, a nationwide analysis conducted in England has shown that diabetes (both types) is associated with a significantly increased CFR by COVID-19 [ 54 ].…”

Section: Discussionmentioning

confidence: 91%

Epidemiological characteristics and initial spatiotemporal visualisation of COVID-19 in a major city in the Middle East

et al. 2021

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Background The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) emerged initially in China in December 2019 causing the COVID-19 disease, which quickly spread worldwide. Iran was one of the first countries outside China to be affected in a major way and is now under the spell of a fourth wave. This study aims to investigate the epidemiological characteristics of COVID-19 cases in north-eastern Iran through mapping the spatiotemporal trend of the disease. Methods The study comprises data of 4000 patients diagnosed by laboratory assays or clinical investigation from the beginning of the disease on Feb 14, 2020, until May 11, 2020. Epidemiological features and spatiotemporal trends of the disease in the study area were explored by classical statistical approaches and Geographic Information Systems. Results Most common symptoms were dyspnoea (69.4%), cough (59.4%), fever (54.4%) and weakness (19.5%). Approximately 82% of those who did not survive suffered from dyspnoea. The highest Case Fatality Rate (CFR) was related to those with cardiovascular disease (27.9%) and/or diabetes (18.1%). Old age (≥60 years) was associated with an almost five-fold increased CFR. Odds Ratio (OR) showed malignancy (3.8), nervous diseases (2.2), and respiratory diseases (2.2) to be significantly associated with increased CFR with developments, such as hospitalization at the ICU (2.9) and LOS (1.1) also having high correlations. Furthermore, spatial analyses revealed a geographical pattern in terms of both incidence and mortality rates, with COVID-19 first being observed in suburban areas from where the disease swiftly spread into downtown reaching a peak between 25 February to 06 March (4 incidences per km2). Mortality peaked 3 weeks later after which the infection gradually decreased. Out of patients investigated by the spatiotemporal approach (n = 727), 205 (28.2%) did not survive and 66.8% of them were men. Conclusions Older adults and people with severe co-morbidities were at higher risk for developing serious complications due to COVID-19. Applying spatiotemporal methods to identify the transmission trends and high-risk areas can rapidly be documented, thereby assisting policymakers in designing and implementing tailored interventions to control and prevent not only COVID-19 but also other rapidly spreading epidemics/pandemics.

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Section: Discussionmentioning

confidence: 91%

Epidemiological characteristics and initial spatiotemporal visualisation of COVID-19 in a major city in the Middle East

et al. 2021

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“… 9 - 11 Cardiac rehabilitation is a medical intervention designed to improve patient care that not only reduces mortality and morbidity but also improves the life quality of the patients. 12 However, few studies have been conducted to assess the role of miR-423-5p in hypertensive patients with heart failure with a moderately reduced ejection fraction (HFmrEF), and it remains to be determined how cardiac rehabilitation affects circulating miR-423-5p in these patients.…”

Section: Introductionmentioning

confidence: 99%

Functional Significance of Cardiac Rehabilitation-Regulated Expression of Circulating MicroRNA-423-5p in Hypertensive Patients with Heart Failure with a Moderately Reduced Ejection Fraction

Huang¹,

Zhang²,

Nong³

et al. 2022

Anatolian J Cardiol

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Background Hypertension is a vital risk factor for heart failure, while cardiac rehabilitation can effectively improve cardiac function of heart failure patients. This study aimed to determine the impact of cardiac rehabilitation on microRNA-423-5p in hypertensive patients with heart failure with a moderately reduced ejection fraction. Methods Sixty hypertensive patients with heart failure with a moderately reduced ejection fraction were randomly divided into cardiac rehabilitation group and positive control group with 30 cases per group, while 30 hypertensive patients without heart failure were recruited as negative control group. The cardiac rehabilitation group and positive control group were treated with 1-month cardiac rehabilitation combined with the routine treatment and routine treatment only, respectively. The New York Heart Association classification, 6-minute walking test, and color Doppler echocardiography were adopted to detect cardiac function. Meanwhile, the expression of microRNA-423-5p and N-terminal pro-B-type natriuretic peptide was determined via Real-Time Fluorescence Quantitative PCR and electrochemiluminescence immunoassay. The diagnostic potential of microR-423-5p and N-terminal pro-B-type natriuretic peptide was assessed by ROC curve analysis and multivariate linear regression model. Results Patients in cardiac rehabilitation group displayed significantly lower expression of microR-423-5p and better results of New York Heart Association classification, 6-minute walking test, and color Doppler echocardiography than those in positive control group ( P < .05). ROC analysis showed that microR-423-5p (AUC = 0.785; 95% CI: 0.686-0.865; sensitivity = 73.33%; specificity = 73.33%) had better specificity and accuracy than N-terminal pro-B-type natriuretic peptide (AUC = 0.721; 95% CI: 0.617-0.811; sensitivity = 81.67%; specificity = 63.33%). Conclusion MicroR-423-5p was implicated in left ventricular hypertrophy and might be a potential biomarker for assessing the therapeutic effect of cardiac rehabilitation on hypertensive patients with heart failure with a moderately reduced ejection fraction.

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“…To determine the intensity of aerobic exercise, THR and Borg's rating of perceived exertion (RPE) scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), depending on the choice of subjects, were used. RPE is a reliable indicator for monitoring exercise intensity.…”

Section: Rhr] (19)mentioning

confidence: 99%

“…Hence, telemonitoring exercises, such as home-based training (HBT) programs can emerge as alternatives for increasing com-pliance with gym-based training (GBT) programs. Doing HBT with telemonitoring guidance improves the quality of life, the feeling of empowerment in changing the lifestyle, and self-efficacy in patients (13,14). The HBT may increase physical activity adherence among people with limited access to gym equipment and facilities.…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Gym- and Home-based Training on Plasma TXNIP Level, Insulin Sensitivity, and Lipid Profile in Hypertensive Men: A Randomized Controlled Trial

Masoudi¹,

Saghebjoo²,

Toba³

et al. 2022

Middle East J Rehabil Health Stud

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Background: Thioredoxin-interacting protein (TXNIP) is a possible factor in the relationship between metabolism and cellular redox state and plays a key role in the regulation of glucose and lipid metabolism. Objectives: The present study aimed at evaluating the effects of combined training in the gym and at home on TXNIP plasma level, insulin sensitivity, and lipid profile in men with primary hypertension. Methods:In this randomized controlled trial, sixty hypertensive men (age 48 ± 9 years, BMI 30 ± 4 kg/m 2 ) were randomly assigned to the gym-based training (GBT: ten weeks, four days/week of moderate-intensity resistance and aerobic training followed by stretching exercises), home-based training (HBT: the type, duration, and intensity were similar to the GBT), and control groups. Selected blood biochemical parameters were measured at baseline and after ten weeks of training programs. Results:The plasma levels of TXNIP in the GBT (P = 0.04) and HBT (P = 0.0001) groups decreased significantly compared to the control group. Moreover, the levels of plasma total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) decreased and insulin sensitivity increased following GBT (GBT group (P = 0.03), HBT group (P = 0.02), and control group (P = 0.01)) compared to the control group, with no significant difference observed between GBT and HBT (P = 0.47, P = 0.36 and P = 0.14, respectively). Conclusions: GBT was more effective compared to HBT in positive changes in blood glucose and lipid profile. However, HBT improved some important biochemical parameters and can be an alternative to complementary strategies strategy instead of GBT. Our data manifest that combined training has a positive effect on reducing the protein level, which negatively affects glucose and lipid metabolism in hypertensive men.

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Cost-utility analysis of home-based cardiac rehabilitation as compared to usual post-discharge care: systematic review and meta-analysis of randomized controlled trials

Cited by 15 publications

References 93 publications

Epidemiological characteristics and initial spatiotemporal visualisation of COVID-19 in a major city in the Middle East

Epidemiological characteristics and initial spatiotemporal visualisation of COVID-19 in a major city in the Middle East

Functional Significance of Cardiac Rehabilitation-Regulated Expression of Circulating MicroRNA-423-5p in Hypertensive Patients with Heart Failure with a Moderately Reduced Ejection Fraction

The Effect of a Gym- and Home-based Training on Plasma TXNIP Level, Insulin Sensitivity, and Lipid Profile in Hypertensive Men: A Randomized Controlled Trial

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