How much do the benefits cost? Effects of a home-based training programme on cardiovascular fitness, quality of life, programme cost and adherence for patients with coronary disease

Salvetti, Xiomara Miranda; Oliveira, Japy Angelini; Servantes, Denise Maria; Paola, Ângelo Amato Vincenzo de

doi:10.1177/0269215508093331

Cited by 47 publications

(61 citation statements)

References 23 publications

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“…For example, motivational letters in particular are a very low-cost intervention, which warrant testing in such contexts. The structured health professional-led contacts via phone calls or home visits has been practiced in MICs, particularly with the home-based CR model in Iran as well as in Brazil, where such models of CR are reported to have low cost [29,68].…”

Section: Discussionmentioning

confidence: 99%

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

Turk-Adawi

Grace

2015

Heart, Lung and Circulation

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Background-Cardiovascular disease is a leading cause of morbidity worldwide. Cardiac rehabilitation (CR) is a comprehensive secondary prevention approach, with established benefits in reducing morbidity in high-income countries (HICs). The objectives of this review were to summarize what is known about the benefits of CR, including consideration of cost-effectiveness, in addition to rates of CR participation and adherence in high-, as well as low-and middle-income countries (LMICs).

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Section: Discussionmentioning

confidence: 99%

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

Turk-Adawi

Grace

2015

Heart, Lung and Circulation

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“…The cost of administering CR is poorly studied, with only a few small studies in the area. 28 A simplified cost analysis with some attendant assumptions was included as part of a recent Canadian CR study. The cost-utility ratio those investigators found for CR ($6000 per life-year gained) was within an economically attractive threshol" for costeffectiveness.…”

Section: Discussionmentioning

confidence: 99%

Cardiac Rehabilitation Attendance and Outcomes in Coronary Artery Disease Patients

Hauer²,

et al. 2012

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Background-Cardiac rehabilitation (CR) is an efficacious yet underused treatment for patients with coronary artery disease.The objective of this study was to determine the association between CR completion and mortality and resource use. Methods and Results-We conducted a prospective cohort study of 5886 subjects (20.8% female; mean age, 60.6 years) who had undergone angiography and were referred for CR in Calgary, AB, Canada, between 1996 and 2009. Outcomes of interest included freedom from emergency room visits, hospitalization, and survival in CR completers versus noncompleters, adjusted for clinical covariates, treatment strategy, and coronary anatomy. Hazard ratios for events for CR completers versus noncompleters were also constructed. A propensity model was used to match completers to noncompleters on baseline characteristics, and each outcome was compared between propensity-matched groups. Of the subjects referred for CR, 2900 (49.3%) completed the program, and an additional 554 subjects started but did not complete CR. CR completion was associated with a lower risk of death, with an adjusted hazard ratio of 0.59 (95% confidence interval, 0.49 -0.70). CR completion was also associated with a decreased risk of all-cause hospitalization (adjusted hazard ratio, 0.77; 95% confidence interval, 0.71-0.84) and cardiac hospitalization (adjusted hazard ratio, 0.68; 95% confidence interval, 0.55-0.83) but not with emergency room visits. Propensity-matched analysis demonstrated a persistent association between CR completion and reduced mortality. Conclusions-Among those coronary artery disease patients referred, CR completion is associated with improved survival and decreased hospitalization. There is a need to explore reasons for nonattendance and to test interventions to improve attendance after referral. (Circulation. 2012;126:677-687.)

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“…In general, it appears the telerehabilitation group improved significantly from baseline in quality of life for patients with cardiac (Chien et al, 2011;Oka et al, 2000;Salvetti et al, 2008;Servantes et al, 2011) and respiratory conditions (Maltais et al, 2008;Oh, 2003). For example, when considering the amount of improvement in quality of life compared with baseline, the difference (95% CI) between telerehabilitation and no intervention was seven (1 to 12) points on the 105-point Minnesota living with heart failure questionnaire (Chien et al, 2011).…”

Section: Quality Of Lifementioning

confidence: 96%

“…Two studies found no significant difference in post-program VO2peak between telerehabilitation and no intervention in patients with cardiac conditions (see Figure 2-3) (Brubaker et al, 2000;Oka et al, 2000). Conversely, some studies found a significant improvement in VO2peak following telerehabilitation for patients with cardiac conditions, whereas no intervention group showed a decline (Salvetti et al, 2008;Servantes et al, 2011). Factors contributing to this discrepancy remain unclear.…”

Section: Vo2peakmentioning

confidence: 99%

“…Some studies used a generic tool to assess quality of life (Arthur et al, 2002;Piotrowicz et al, 2010;Salvetti et al, 2008), while others used a disease-specific tool (Chien et al, 2011;Oh, 2003;Oka et al, 2000;Servantes et al, 2011). In general, it appears the telerehabilitation group improved significantly from baseline in quality of life for patients with cardiac (Chien et al, 2011;Oka et al, 2000;Salvetti et al, 2008;Servantes et al, 2011) and respiratory conditions (Maltais et al, 2008;Oh, 2003).…”

Section: Quality Of Lifementioning

confidence: 99%

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Providing heart failure rehabilitation in the home via telerehabilitation

Hwang¹

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Exercise is effective for patients with chronic heart failure (CHF). Despite this, many patients are unable to access traditional exercise-based rehabilitation programs for various reasons, such as transport difficulties and program availability. Telerehabilitation, in which telecommunication technologies are used to provide rehabilitation at a distance, is an alternative approach which may overcome some of these barriers.The current literature suggests that telerehabilitation is effective in patients with cardiopulmonary diseases. However the majority of studies focus on phone-based interventions, so there is a need for more studies on the use of video-based telerehabilitation programs. Video-based telerehabilitation is a new approach which enables patients to exercise in the comfort of their homes, whilst maintaining synchronous audiovisual communication. This approach enables the clinician to watch patients performing the exercises and to provide real-time feedback and modification as required, as well as facilitate the development of rapport between the clinician and patients, and peer support amongst patients. Video-based telerehabilitation also presents a potential way to conduct remote assessment of functional exercise capacity.This thesis aimed to explore a new service delivery model for providing heart failure exercise-based rehabilitation programs. The thesis commences with a systematic review of telerehabilitation in patients with cardiopulmonary diseases (Study 1, Paper 1). The next study aimed to determine the suitability of the timed up and go test (TUGT) as an outcome measurement in heart failure rehabilitation programs (Study 2, Paper 2). In addition, the validity and reliability of telerehabilitation assessments of functional tests including the TUGT were examined in patients with CHF (Study 3, Paper 3). A randomised controlled trial determined the feasibility and effectiveness of a home-based heart failure telerehabilitation program compared with a traditional centre-based program (Study 4, Paper 4). A mixed methods study was also conducted to determine patient experiences and perspectives related to a heart failure telerehabilitation program (Study 5, Paper 5).Based on the systematic review of 11 studies, telerehabilitation appears to be a promising alternative to traditional centre-based programs in patients with cardiopulmonary diseases. In particular, telerehabilitation has been shown to improve exercise capacity and quality of life in these patient groups and has higher adherence rates compared with traditional centre-based programs.iii However, suitable outcome measures that can be administered via telerehabilitation are required. A possible outcome measure is the TUGT, which is a quick and easy-to-administer functional test.However prior to using the TUGT as an outcome measure in telerehabilitation studies, it was first important to validate its use in both face-to-face and telerehabilitation environments. The TUGT demonstrated excellent test-retest reliability in patients with C...

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How much do the benefits cost? Effects of a home-based training programme on cardiovascular fitness, quality of life, programme cost and adherence for patients with coronary disease

Abstract: The programme seems to provide an efficient low-cost approach to cardiac rehabilitation in low-risk patients.

Cited by 47 publications

References 23 publications

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

Cardiac Rehabilitation Attendance and Outcomes in Coronary Artery Disease Patients

Providing heart failure rehabilitation in the home via telerehabilitation

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