Article

Finding innovative and cost-efficient care strategies that induce
long-term health benefits in cardiac patients constitutes a big challenge today.
The aim of this Telerehab III follow-up study was to assess whether a 6-month
additional cardiac telerehabilitation programme could induce long-term health
benefits and remain cost-efficient after the tele-intervention ended.
Results - A total of 126 cardiac patients first completed the multicentre,
randomised controlled telerehabilitation trial (Telerehab III, time points t0 to
t1). They consequently entered the follow-up study (t1) with evaluations 2 years
later (t2). A quantitative analysis of peak aerobic capacity (VO2 peak, primary
endpoint), international physical activity questionnaire self-reported physical
activity and HeartQoL quality of life (secondary endpoints) was performed. The
incremental cost-effectiveness ratio was calculated. Even though a decline in VO2
peak (24 +/- 8 ml/[min*kg] at t1 and 22 +/- 6 ml/[min*kg] at t2; P </= 0.001) was
observed within the tele-intervention group patients; overall they did better
than the no tele-intervention group ( P = 0.032). Dividing the incremental cost
(-euro878/patient) by the differential incremental quality-adjusted life years
(QALYs) (0.22 QALYs) yielded an incremental cost-effectiveness ratio of
-euro3993/QALY. Conclusions A combined telerehabilitation and centre-based
programme, followed by transitional telerehabilitation induced persistent health
benefits and remained cost-efficient up to 2 years after the end of the
intervention. A partial decline of the benefits originally achieved did occur
once the tele-intervention ended. Healthcare professionals should reflect on how
innovative cost-efficient care models could be implemented in standard care.
Future research should focus on key behaviour change techniques in
technology-based interventions that enable full persistence of long-term
behaviour change and health benefits. This study is registered in the ISRCTN
registry (ISRCTN29243064).
- Télémédecine

Langue : ANGLAIS