TUESDAY, May 14, 2019 (Pharmacist's Briefing) -- For low- to moderate-risk patients, home-based cardiac rehabilitation (HBCR) may be a reasonable alternative to center-based cardiac rehabilitation (CBCR), according to a joint scientific statement issued by the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. The statement was published online May 13 in Circulation, the Journal of the American College of Cardiology, and the Journal of Cardiopulmonary Rehabilitation and Prevention.
Randal J. Thomas, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues address HBCR as a potential new delivery strategy and note that CR programs are significantly underused, with only a minority of eligible patients participating in CR in the United States.
The authors note that HBCR relies on remote coaching with indirect exercise supervision and is mainly provided outside the traditional center-based setting in contrast to CBCR services that are provided in a medically supervised facility. Most U.S. health care organizations have little to no experience with HBCR, although it has been successfully deployed in the United Kingdom, Canada, and other countries. Low- to moderate-strength evidence has shown that HBCR and CBCR can achieve similar improvements in three- to 12-month clinical outcomes. Additional research is needed to clarify and extend the evidence base for HBCR for key subgroups, including older adults, women, minority groups, and other higher-risk and understudied groups.
"There is an urgent need to find new ways of delivering cardiac rehabilitation programs to patients," Thomas said in a statement. "Home-based care is an excellent option for some patients who aren't able to attend a center-based program."
One author disclosed financial ties to NimbleHeart.