Article

Although cardiac rehabilitation improves physical fitness after a cardiac
event, many eligible patients
do not participate in cardiac rehabilitation and
the beneficial effects of cardiac rehabilitation are often not maintained over
time. Home-based training with telemonitoring guidance could improve
participation rates and enhance long-term effectiveness. Methods and results - We
randomised 90 low-to-moderate cardiac risk patients entering cardiac
rehabilitation to three months of either home-based training with telemonitoring
guidance or centre-based training. Although training adherence was similar
between groups, satisfaction was higher in the home-based group ( p = 0.02).
Physical fitness improved at discharge ( p < 0.01) and at one-year follow-up ( p
< 0.01) in both groups, without differences between groups (home-based p = 0.31
and centre-based p = 0.87). Physical activity levels did not change during the
one-year study period (centre-based p = 0.38, home-based p = 0.80). Healthcare
costs were statistically non-significantly lower in the home-based group (euro437
per patient, 95% confidence interval -562 to 1436, p = 0.39). From a societal
perspective, a statistically non-significant difference of euro3160 per patient
in favour of the home-based group was found (95% confidence interval -460 to
6780, p = 0.09) and the probability that it was more cost-effective varied
between 97% and 75% (willingness-to-pay of euro0 and euro100,000 per
quality-adjusted life-years, respectively). Conclusion - We found no differences
between home-based training with telemonitoring guidance and centre-based
training on physical fitness, physical activity level or health-related quality
of life. However, home-based training was associated with a higher patient
satisfaction and appears to be more cost-effective than centre-based training. We
conclude that home-based training with telemonitoring guidance can be used as an
alternative to centre-based training for low-to-moderate cardiac risk patients
entering cardiac rehabilitation.

Langue : ANGLAIS