Virtual cardiac rehabilitation solutions, evaluated across 113 studies, provided mixed efficacy in improving functional capacity (the primary outcome in 32.7% of studies) over conventional methods.
Systematic Review (n=113)
Do virtual healthcare solutions improve functional capacity, adherence, physical activity, and quality of life in patients undergoing cardiac rehabilitation compared to conventional rehabilitation?
Virtual cardiac rehabilitation shows mixed efficacy compared to conventional rehabilitation but offers potential for increased user adherence and longer-term patient engagement.
Adherence to cardiac rehabilitation following a primary event has been demonstrated to improve quality of life, increase functional capacity, and decrease hospitalizations and mortality. Mobile technologies offer an opportunity to improve both the quality and utilization of cardiac rehabilitation, and recent clinical studies investigated this technology. This literature review summarizes the current use of mobile health, wearable activity monitors (WAMs), and other multi-component technologies deployed to support home-based virtual cardiac rehabilitation. The methodology was adapted from the Cochrane Handbook for Systematic Reviews of Interventions. We identified 2094 records, of which 113 were eligible for qualitative analysis. Different virtual cardiac rehabilitation solutions were implemented in the studies: (i) multi-component interventions in 48 studies (42.5%), (ii) WAMs in 27 studies (23.9%), (iii) web-based communications solutions, and (iv) mobile apps, both in 19 studies (16.4%). Functional capacity was the most frequently reported primary outcome (k = 37, 32.7%), followed by user adherence/compliance (k = 35, 31.0%), physical activity (k = 27, 23.9%), and quality of life (k = 14, 12.4%). Studies provided a mixed assessment of the efficacy of virtual cardiac rehabilitation in attaining either significant improvements over baseline or significant improvements in outcomes compared with conventional rehabilitation. Efficacy outcomes with virtual cardiac rehabilitation sometimes improve on the centre-based outcomes; however, superior clinical efficacy may not necessarily be the only outcome of interest. The promise of virtual cardiac rehabilitation includes the potential for increased user adherence and longer-term patient engagement. If these outcomes can be improved, that would be a significant justification for using this technology.
Lee et al. (Thu,) conducted a systematic review in Cardiac rehabilitation (n=113). Virtual cardiac rehabilitation vs. Conventional rehabilitation was evaluated on Functional capacity, user adherence/compliance, physical activity, and quality of life. Virtual cardiac rehabilitation solutions, evaluated across 113 studies, provided mixed efficacy in improving functional capacity (the primary outcome in 32.7% of studies) over conventional methods.