Home-based versus centre-based cardiac rehabilitation: Abridged Cochrane systematic review and meta-analysis

S Buckingham, Catherine Jolly, Rod S Taylor, A Zawada, SG Dean, A Cowie, RJ Norton, HM Dalal

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    Abstract

    Abstract (250 words)
    Objective: To update the Cochrane review comparing the effects of home-based
    and supervised centre-based cardiac rehabilitation (CR) on mortality and morbidity, quality of life, and modifiable cardiac risk factors in patients with heart disease.
    Methods: Systematic review and meta-analysis. The Cochrane Central Register of
    Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and CINAHL were
    searched up to October 2014, without language restriction. Randomised trials
    comparing home- and centre-based CR programmes in adults with myocardial
    infarction, angina, heart failure or who had undergone coronary revascularisation were included.
    Results: 17 studies with 2172 patients were included. No difference was seen
    between home- and centre-based CR in terms of: mortality (relative risk (RR) 0.79, 95% confidence interval 0.43 to 1.47); cardiac events; exercise capacity (mean difference (MD): -0.10, -0.29 to 0.08); total cholesterol (MD: 0.07 mmol/l, -0.24 to 0.11); LDL cholesterol (MD: -0.06 mmol/l, -0.27 to 0.15); triglycerides (MD: -0.16 mmol/l, -0.38 to 0.07); systolic blood pressure (MD: 0.2 mmHg, -3.4 to 3.8); smoking (RR: 0.98, 0.79 to 1.21); health-related quality of life; and healthcare costs. Lower triglycerides (MD: -0.18 mmol/l, -0.34 to -0.02), Llower HDL cholesterol (MD: -0.07 mmol/l, -0.11 to -0.03, P = 0.001) and lower diastolic blood pressure (MD: -1.9 mmHg, -0.8 to -3.0, P = 0.009) were observed in centre-based participants. Homebased CR was associated with slightly higher adherence (RR: 1.04, 95% CI 1.01 to

    Conclusions:
    Home- and centre-based CR provide similar benefits in terms of
    clinical and health-related quality of life outcomes at equivalent cost for those with heart failure and following myocardial infarction and revascularisation.
    Original languageEnglish
    Article numbere000463
    JournalOpen Heart
    Volume3
    Early online date14 Sep 2016
    DOIs
    Publication statusPublished - 2016

    Keywords

    • Cardiac rehabilitation
    • systematic review
    • meta-analysis
    • Coronary artery disease
    • Heart failure

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