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Cardiac rehabilitation (CR), a combination of supervised exercise, health education and psychological intervention, is effective in patients with heart failure (HF) or after an acute coronary heart disease (CHD) event to reduce re-hospitalisation and other adverse cardiovascular outcomes and to improve quality of life. However, CR delivery at healthcare centres is costly and often inconvenient for patients. Home-based CR now is possible using electronic communication between the CR team and patients, with incorporation of personal wearable monitoring devices as needed. In order to assess the potential cost-effectiveness of home-based, compared with healthcare centre-based CR, Shields and colleagues1 performed a systematic review of studies that included both cost and effects of home-based CR. The nine studies that met the inclusion criteria used several methods of CR delivery, a variety of care components and variable programme duration. Even so, using the health status metric of quality-adjusted life years, most studies found that home-based CR was cost-effective compared with healthcare centre-based programmes.
Taylor and Fraser2 conclude in an editorial that the systemic review by “Shields et al 1 shows that home-based/digitally supported delivery models of CR have similar costs and health outcomes to centre-based programmes. Armed with this latest evidence, surely, it is time to ensure consistent access to ‘modern’ rehabilitation services for our patients with CHD and HF.”
Management of atrial arrhythmias in patients with a pre-existing left atrial appendage …
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Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.