A 12-week home-based cardiac rehabilitation program significantly reduced the composite of death, MI, stroke, and cardiac hospitalization compared to Community Care (P=0.002).
Cohort (n=272)
Does a 12-week home-based cardiac rehabilitation program reduce composite cardiovascular events and improve physical function in patients with cardiovascular disease compared to community care or usual care?
A 12-week home-based cardiac rehabilitation program significantly improved physical function, reduced composite cardiovascular events, and lowered healthcare costs compared to community care.
valor p: p=0.002
PURPOSE: Cardiac rehabilitation (CR) improves health outcomes in patients with cardiovascular disease (CVD), but referral, participation, and completion rates are low. Home-based CR (HBCR) is a proposed solution, but studies on its efficacy are limited. We report our experience from a Veterans Affairs HBCR program on physical function, costs, and outcomes overlapping with the coronavirus disease-2019 (COVID-19) pandemic. METHODS: A 12-week HBCR program included case-managed individualized exercise and risk management. Six functional tests were conducted remotely, safety was monitored, and quality of life and costs were quantified. A composite outcome (death, myocardial infarction, stroke, and cardiac-related hospitalization) was compared between 70 HBCR participants, 131 patients referred to Community Care, and 71 patients undergoing usual care (no CR) over a mean follow-up of 2. 5 ± 0. 90 years. RESULTS: Among HBCR participants, there were significant improvements in right and left leg balance (145 and 56%, respectively, P <. 001), 30-second chair stand (47%, P <. 001), 2-minute step performance (41%, P <. 001), right and left 30-second arm curl (31 and 30%, respectively, P <. 001), 50-foot walk test (20%, P =. 002), 8-foot up and go test (28%, P <. 001), and steps/day (82%, P <. 001). Composite events were lower among patients in the HBCR group versus those referred to Community Care (P =. 002). Health care costs were significantly lower among patients in the HBCR group compared to those in Community Care (2101 vs 3289/subject, P <. 001). CONCLUSIONS: A HBCR program that included a broad spectrum of patients with CVD and multiple co-morbidities, performed largely during the COVID-19 pandemic, resulted in significant functional and outcome benefits and reduced costs.
Myers et al. (Tue,) conducted a cohort in Cardiovascular disease (n=272). Home-based cardiac rehabilitation (HBCR) vs. Community Care or usual care (no CR) was evaluated on Composite outcome (death, myocardial infarction, stroke, and cardiac-related hospitalization) (p=0.002). A 12-week home-based cardiac rehabilitation program significantly reduced the composite of death, MI, stroke, and cardiac hospitalization compared to Community Care (P=0.002).