Patient Outcomes From Home-Based Virtual Cardiac Rehabilitation Within a Large Integrated Healthcare System

Cardiac rehabilitation can improve patient outcomes and reduce the risk of recurrent cardiac events. Virtual home-based programs may support patient access and participation if feasible and effective. Among all eligible patients with a cardiac event (myocardial infarction, coronary artery bypass graft, or percutaneous coronary intervention) between 2016 and 2022, within a multisite integrated delivery system offering a virtual home-based Cardiac Rehabilitation Program, we examined the association between cardiac rehabilitation exposure and return emergency department visits or hospitalizations, major adverse cardiovascular event events, and revascularization during a 1-year period after rehabilitation, using propensity weighted multivariate analyses to balance rehabilitation and nonrehabilitation groups. Among 25,552 eligible patients across 21 medical centers, 7,077 (27.7%) enrolled in home-based virtual cardiac rehabilitation and received three or more intervention encounters. After adjustment, cardiac rehabilitation exposure was associated with a higher risk of all-cause emergency department visits (Adjusted RR: 1.08, 95% confidence interval [CI] 1.05 to 1.12) and a significantly lower risk of hospitalizations (Adjusted RR 0.86, 95% CI 0.81 to 0.90). We found no statistically significant association with major adverse cardiovascular event and revascularization events. Cardiac rehabilitation was, however, associated with a significantly lower rate of 1-year mortality (Adjusted RR 0.68, 95% CI 0.60 to 0.76). In conclusion, virtual home-based cardiac rehabilitation was associated with lower hospitalization and mortality, showing feasibility and effectiveness for improving cardiac outcomes. Further attention may be given to increasing patient engagement, given the relative convenience of a home-based virtual program.