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Optimizing cardiac telerehabilitation programs: psychological, social, and implementation factors
Valentina Micheluzzi1, Pierluigi Merella1, Francesco Burrai2
1Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy; Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy.
Current Problems in Cardiology
|February 14, 2026
Summary
Cardiac telerehabilitation (tele-CR) improves access to care by addressing barriers. Optimizing tele-CR requires focusing on patient engagement, relationships, and tailored, equitable design for better outcomes.
Area of Science:
- Cardiology
- Digital Health
- Rehabilitation Medicine
Background:
- Cardiac telerehabilitation (tele-CR) offers home-based or hybrid models to overcome travel and time barriers in cardiac rehabilitation.
- Tele-CR effectiveness is influenced by patient engagement, therapeutic relationships, and implementation factors.
- This review synthesizes evidence on optimizing tele-CR through psychological, social, and implementation strategies.
Purpose of the Study:
- To review psychological, social, and implementation factors influencing cardiac telerehabilitation (tele-CR) uptake, adherence, and effectiveness.
- To identify strategies for optimizing the delivery of home-based and hybrid cardiac rehabilitation programs.
- To synthesize evidence on enhancing the patient experience and clinical outcomes in tele-CR.
Main Methods:
- A targeted literature search was conducted across PubMed, Scopus, PsycINFO, and Embase from January 2021 to January 2026.
- Included studies encompassed randomized and observational designs, qualitative and mixed-methods research, and systematic reviews/meta-analyses.
- The review focused on adults with cardiovascular disease participating in various forms of tele-CR, adhering to SANRA reporting guidelines.
Main Results:
- Tele-CR is a sociotechnical intervention integrating digital tools, clinical workflows, and patient contexts.
- Self-monitoring and feedback enhance self-efficacy when data are actionable; routine check-ins and responsive follow-up improve continuity.
- An equity-by-design approach tailoring delivery to individual needs (connectivity, literacy, language) is crucial for feasibility and acceptability.
Conclusions:
- Scalable benefits of tele-CR depend on relationship-centered, equity-oriented service design.
- Key priorities include calibrating monitoring to clinical actionability, simplifying interfaces, integrating mental health screening, and supporting caregivers.
- Embedding implementation metrics and continuous quality improvement is essential for optimizing tele-CR outcomes.
Keywords:
Cardiac rehabilitationPsychological supportQuality of lifeSocial supportTelemedicineTelerehabilitationMore Related Videos
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