What question did this study set out to answer?

To evaluate the clinical effectiveness and economic outcomes of home-based secondary prevention programs compared to usual care and hospital-based cardiac rehabilitation in patients with coronary heart disease.

March 1, 2010European Journal of Cardiovascular Prevention & Rehabilitation

A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease

View Full Paper

Ask AI

Bookmark

Why the study?

Do home-based secondary prevention programs improve risk factors and quality of life in patients with coronary heart disease compared to usual care or cardiac rehabilitation?

Population

Patients with coronary heart disease (CHD) from 36 randomized trials

Comparison

Home-based secondary prevention programs… vs Usual care or cardiac rehabilitation

Design

Meta-analysis

Authors

ACAlexander M. ClarkHeart Failure & Transplant MHMark J. HaykowskyHeart Failure / Cardiomyopathy JKJennifer KryworuchkoUniversity of British Columbia

Discussion

Member takes

Implication

Supports home-based CHD secondary prevention; extends Level 1 evidence for flexible models versus usual care.

Key Points

To evaluate the clinical effectiveness and economic outcomes of home-based secondary prevention programs compared to usual care and hospital-based cardiac rehabilitation in patients with coronary heart disease.
Systematic search across 19 databases and reference lists for randomized controlled trials published in English as full articles or theses.
Included 36 randomized controlled trials (reported across 39 articles) evaluating home-based interventions targeting multiple coronary heart disease risk factors versus usual care or cardiac rehabilitation.
Compared with usual care, home-based interventions significantly improved quality of life (weighted mean difference: 0.23; 95% CI: 0.02 to 0.45) and systolic blood pressure (weighted mean difference: -4.36 mmHg; 95% CI: -6.50 to -2.22).
Home-based care increased smoking cessation (difference in proportion: 14%; 95% CI: 0.02 to 0.26), lowered total cholesterol (standardized mean difference: -0.33; 95% CI: -0.57 to -0.08), and reduced depression (standardized mean difference: -0.33; 95% CI: -0.59 to -0.07).
Direct comparisons with cardiac rehabilitation could not be established due to an insufficient number of trials and high heterogeneity among low-to-moderate quality studies.

Structured PICO

Do home-based secondary prevention programs improve risk factors and quality of life in patients with coronary heart disease compared to usual care or cardiac rehabilitation?

Population

Patients with coronary heart disease (CHD) from 36 randomized trials

Intervention

Home-based secondary prevention programs addressing more than one main CHD risk factor

Comparator

Usual care or cardiac rehabilitation

Outcome

Quality of life, systolic blood pressure, smoking cessation, total cholesterol, and depression

Home-based secondary prevention programs for CHD are an effective complement to hospital-based cardiac rehabilitation, improving quality of life and risk factors compared to usual care.

Limitations

Effect sizes were small to moderate
Trials were of low-to-moderate quality
Comparisons with cardiac rehabilitation could not be made because of the small number of trials and high levels of heterogeneity

Cite This Study

Clark et al. (2010) studied this question.

synapsesocial.com/papers/6a100e0092676d5461fd772d https://doi.org/10.1097/hjr.0b013e32833090ef

Topics

Coronary artery disease

View Full Paper

Ask AI

Bookmark

A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Topics

A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Also Consider

Topics

Also Consider