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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Home-Based Cardiac Rehabilitation in Brazil's Public Health Care: Protocol for a Randomized Controlled Trial
Ana Paula Lima1, Isabella Oliveira Nascimento1, Anne Caroline A Oliveira1
1Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Insights
This study compares traditional cardiac rehabilitation with a novel home-based program for coronary artery disease (CAD) patients. The home-based approach, using telephone guidance, aims to improve accessibility and reduce costs for CAD management.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Coronary artery disease (CAD) is a leading cause of global mortality and hospitalization.
- Supervised cardiac rehabilitation (CR) improves CAD outcomes but faces participation barriers, especially in low-resource settings.
- Traditional CR programs often involve face-to-face sessions, limiting accessibility for some patients.
Purpose of the Study:
- To assess patient compliance with a home-based CR program guided by telephone.
- To compare the effectiveness of home-based CR with traditional center-based CR.
- To evaluate the feasibility and cost-effectiveness of a novel, accessible CR model.
Main Methods:
- A randomized controlled trial comparing center-based (CenterRehab) and home-based (Home-Based) CR in 72 CAD patients.
- The primary outcome is compliance; secondary outcomes include functional capacity, CAD risk factors, quality of life, disease knowledge, and morbidity.
- Both 12-week programs include supervised and home sessions, with the Home-Based group receiving telephone guidance.
Main Results:
- Participant recruitment is ongoing.
- Data collection is expected to conclude in October 2019.
- No results are available yet as the study is in the recruitment phase.
Conclusions:
- This study pioneers the comparison of traditional CR with a novel, low-cost, home-based protocol in Brazil.
- Positive findings could establish a new, viable model for widespread cardiac rehabilitation.
- The research addresses accessibility challenges in CR delivery.
Background:
Coronary artery disease (CAD) is among the main causes of hospitalization and death worldwide, therefore, the implementation of programs to reduce its impact is necessary. Supervised cardiac rehabilitation has been shown to have positive effects on CAD control. However, there are barriers to patient participation in the traditional, face-to-face cardiac rehabilitation programs, mainly in low-resource environments.
Objective:
This study aimed to verify patient compliance to a home-based cardiac rehabilitation program, which includes unsupervised health education and physical exercises, guided by telephone. Moreover, we compare this new method to the traditional supervised cardiac rehabilitation offered in most hospital centers.
Methods:
We present here a two-arm, single-blinded, and randomized controlled design protocol, which compares the traditional cardiac rehabilitation (CenterRehab) with the home-based cardiac rehabilitation (Home-Based) in 72 patients affected by CAD. The primary outcome is the compliance to the cardiac rehabilitation sessions. The secondary outcomes (to evaluate effectiveness) include measurable variables such as functional capacity, CAD risk factors (blood pressure, waist circumference, glycemic, cholesterol levels, depressive symptoms, and the level of physical activity), the patient's quality of life, the disease knowledge, and the morbidity rate. Parameters such as the program cost and the usability will also be evaluated. The programs will last 12 weeks, with a total of 60 rehabilitation and 6 educational sessions. Patients of the CenterRehab program will participate in 24 supervised sessions and 36 home sessions, while the patients of the Home-Based program will participate in 2 supervised sessions and 58 home sessions, guided by telephone. After the 12-week period all participants will be recommended to continue practicing physical exercises at home or at a community center, and they will be invited for re-evaluation after 3 months. The outcomes will be evaluated at baseline, and after 3 and 6 months.
Results:
Participants are currently being recruited for the trial. Data collection is anticipated to be completed by October 2019.
Conclusions:
This is the first study in Brazil comparing the traditional cardiac rehabilitation approach with a novel, home-based protocol that uses an accessible and low-cost technology. If positive results are obtained, the study will contribute to establish a new and viable model of cardiac rehabilitation.
Trial Registration:
ClinicalTrials.gov NCT03605992; https://clinicaltrials.gov/ct2/show/NCT03605992.
International Registered Report Identifier (Irrid):
DERR1-10.2196/13901.
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