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.
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 language | English |
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Article number | e000463 |
Journal | Open Heart |
Volume | 3 |
Early online date | 14 Sept 2016 |
DOIs | |
Publication status | Published - 2016 |
Keywords
- Cardiac rehabilitation
- systematic review
- meta-analysis
- Coronary artery disease
- Heart failure