Effects of Telerehabilitation Interventions on Heart Failure Management (2015-2020): Scoping Review (Preprint)

Abstract

BACKGROUND Heart failure is one of the world’s most frequently diagnosed cardiovascular diseases. An important element of heart failure management is cardiac rehabilitation, which aims to improve patients’ recovery, functional capacity, psychosocial well-being, and health-related quality of life. Patients in cardiac rehabilitation may lack sufficient motivation or feel that the rehabilitation process does not meet their individual needs. One solution to these challenges is the use of telerehabilitation. Although telerehabilitation has been available for several years, it is only in recent years that it has been utilized in heart failure studies. Especially within the past five years, we now have several studies focusing on the effectiveness of telerehabilitation for heart failure management, and the studies show varying results. Based on these studies, this paper provides a review and assessment of the general effectiveness of telerehabilitation as applied to heart failure management. OBJECTIVE The aim of this scoping review is to assess the effects of telerehabilitation in the management of heart failure by systematically reviewing the available scientific literature within the period from January 1st 2015 to December 31st 2020. METHODS The literature search was performed using PubMed and EMBASE. After duplicates were removed, 77 articles were screened and reviewed, of which 12 articles were included in this review. As measures of the effectiveness of telerehabilitation, the following outcomes were used: patient’s quality of life, physical capacity, depression/anxiety, and adherence to the intervention. RESULTS In reviewing the effects of telerehabilitation for heart failure patients, it was found that, 4 out of 6 randomized control trials, the single prospective study, and 4 out of 5 reviews reported increased quality of life for patients. For physical capacity, 4 randomized control trials and 3 systematic reviews revealed increased physical capacity. Depression or depressive symptoms was reported as reduced in 1 of the 6 randomized control trials and in 2 of the 5 reviews. Anxiety or anxiety-related symptoms was only reported as reduced in only 1 review. High adherence to the telerehabilitation program was reported in 4 randomized control trials and 4 reviews. It should be mentioned that some of the reviewed articles described the same studies although they used different outcome measures. CONCLUSIONS Telerehabilitation is still a relatively new approach to heart failure patients. It was found that there is a tendency toward improvement in patients’ quality of life and physical capacity. The outcome measures of depression, anxiety and adherence to the intervention were found to be positive. More research is needed to determine more precise and robust effects on the respective outcomes in telerehabilitation.