Cardiac telerehabilitation in a middle-income country: analysis of adherence, effectiveness and cost through a randomized clinical trial.
Ana P DE Lima, Danielle G Pereira, Isabella O Nascimento and 4 others
PMID 35634888WHAT IT FOUND
Home cardiac rehab cost 44% less than center-based care.
Adherence and health outcomes were similar between the two. But the study was too small to prove the slight adherence advantage for home care was real.
Key findings
01The total cost of the 12-week service was approximately 44% lower for the home-based program compared to the center-based program.
02Participants in the home group attended 94.18% of predicted sessions versus 79.08% in the center group, but this difference was not significant.
03Both groups improved functional capacity and quality of life from pre-program to post-program, with no significant differences between them.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study did not reach its calculated sample size, so it may have missed a true difference in adherence between the groups. Only low and moderate risk patients were included, so these results do not apply to higher-risk cardiac patients. The home group used multiple support tools at once (phone calls, heart-rate monitors, pedometers), so it is unclear which component drove the outcomes. Data on home exercise was recorded manually in diaries, which can be less accurate than electronic logs. The study took place at a single center in one middle-income country, which may limit how well the results apply to other healthcare systems.
Declared interests
The authors declared no conflicts of interest. The study was funded by public sources, and the protocol was registered and published.
The easy way to misread this
Do not conclude that home-based cardiac rehab is significantly more effective at improving adherence than center-based rehab. Although the home group had higher adherence rates, the difference was not statistically significant because the study was underpowered.