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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Asynchronous and Synchronous Delivery Models for Home-Based Cardiac Rehabilitation: A SCIENTIFIC REVIEW
Randal J Thomas1, Cara E Petersen, Thomas P Olson
1Cardiac Rehabilitation Program, Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota (Drs Thomas and Olson and Ms Petersen); Brigham Young University, Provo, Utah (Ms Petersen); Department of Epidemiology and Biostatistics and Department of Medicine (Cardiology), University of California, San Francisco (Dr Beatty); Department of Cardiology, Peiking University People's Hospital, Beijing, China (Dr Ding); and Gregorio Marañón General University Hospital, Gregorio Marañón Health Research Institute, Madrid, Spain (Dr Supervia).
Insights
Home-based cardiac rehabilitation (HBCR) using asynchronous or synchronous models offers flexibility and oversight, showing similar short-term outcomes to center-based programs. Further research is needed to compare long-term impacts across diverse patient groups.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Digital Health
Background:
- Home-based cardiac rehabilitation (HBCR) is an evolving alternative to traditional center-based programs.
- Both asynchronous and synchronous HBCR models have gained traction in recent years.
- Understanding the distinct principles, benefits, and drawbacks of each model is crucial for optimizing patient care.
Purpose of the Study:
- To review the principles, advantages, and disadvantages of asynchronous and synchronous home-based cardiac rehabilitation (HBCR) delivery models.
- To compare these models with center-based cardiac rehabilitation (CBCR).
Main Methods:
- Systematic review of recent publications and randomized studies.
- Assessment of asynchronous and synchronous HBCR principles, outcomes, and limitations.
- Comparison with center-based cardiac rehabilitation (CBCR) outcomes.
Main Results:
- Both asynchronous and synchronous HBCR models deliver core cardiac rehabilitation (CR) components.
- Short-term patient outcomes for both HBCR models are comparable to CBCR in low- to moderate-risk populations.
- Asynchronous HBCR provides flexibility, while synchronous HBCR offers real-time patient feedback and oversight.
Conclusions:
- Asynchronous and synchronous HBCR are viable options for eligible patients.
- Additional research is required to compare the long-term efficacy of both models, individually or combined.
- Further studies should investigate HBCR's impact on diverse patient subgroups and those with higher cardiovascular disease risk.
Purpose:
To review the principles, advantages, and disadvantages of asynchronous and synchronous delivery models of home-based cardiac rehabilitation (HBCR).
Methods:
We reviewed recently published systematic reviews and other publications of randomized studies of asynchronous and synchronous HBCR to assess principles, outcomes, and limitations of those delivery methods compared with center-based cardiac rehabilitation (CBCR).
Summary:
While most studies prior to 2016 involved asynchronous HBCR approaches to care, studies since 2016 have included asynchronous or synchronous delivery models. Both delivery models have been shown to help provide core components of cardiac rehabilitation (CR). Studies using either method have been shown to have similar short-term patient outcomes as CBCR, at least in low- to moderate-risk patients who have been studied. Asynchronous HBCR offers greater flexibility for patients and CR staff, while synchronous HBCR provides greater real-time oversight and feedback to patients.Asynchronous and synchronous HBCR is an option to consider for patients eligible for CR. Additional research is needed for both delivery models, applied separately or in combination, to compare their impact on shorter- and longer-term patient outcomes and to assess their impact in patient subgroups (referral diagnosis, women, elderly, underrepresented racial and ethnic minority groups, patients at a higher cardiovascular disease risk, patients with multiple comorbid conditions, etc).
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