The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review.

The twelve studies used different telehealth tools, exercise schedules, durations, and cost methods, so the review could not combine them statistically or identify the best design. The telehealth programmes included different combinations of devices, platforms, and supervision, so the contribution of any single component cannot be separated. Patients were a mixed group after different cardiovascular events, and the review could not separate cost-effectiveness by subgroup. Most included trials were designed around functional capacity rather than cost, so the cost findings were not the primary outcome in most studies. Economic reporting quality was inconsistent, with an average score of 16.8 out of 28 and only 2 studies meeting the high-quality category. Only English randomised trials were included, and the authors note a lack of evidence from low and middle-income countries. Blinding was not used in 4 of 12 studies, and it is difficult to blind patients and therapists to exercise interventions.

Do not conclude that home-based telerehabilitation is clinically equivalent or universally cost-effective. Most included trials were designed around functional capacity rather than cost, the interventions varied widely, and the review did not combine clinical outcomes statistically.