When we think of places to receive medical treatment and care, hospitals, walk-in clinics, and health centres are likely to be in the mix. Home, although where the heart is, may not be top of mind. But we shouldn’t count it out! From house calls to exercise, home-based strategies continue to be heavily studied (1-6). Next in line for investigation is a highly recommended strategy for one of the most common chronic conditions: heart disease (6;7).
For people living with heart disease, a tailored combination of emotional support, exercise training and promotion, education, and risk management may be added to their recovery and prevention plan (6;8;9). Together, these individual components make up a strategy known as cardiac rehabilitation, which is generally delivered in settings like hospitals and community centres (6;8;10). Despite evidence of its success in helping reduce future illness and improving certain aspects of quality of life, participation remains low (6; 10-13).
It makes sense that allowing people to take part in cardiac rehabilitation from the comfort of their homes would reduce barriers to access and perhaps improve adherence. But is it as effective as centre-based rehabilitation? A recent systematic review shed light on this issue for adults living with heart disease, and specifically those who had chest pain, heart failure, experienced a heart attack, or had undergone surgery to fix blood flow issues (6).
What the research tells us
The review found that home‐based cardiac rehabilitation (including programs that used digital and telehealth technologies) can be comparable to supervised centre-based cardiac rehabilitation. Breaking this down further, evidence shows there were no notable differences between the two strategies when it came to improving exercise capacity (aka the largest amount of physical exertion an individual can maintain), number of deaths, and health-related quality of life. Our certainty in the findings ranges from low to moderate, therefore future research may find different results for some outcomes. More research is also needed for a better understanding of how these findings hold up in the long term (6).
So, what does this mean for people living with heart disease? Options! If there’s access to both strategies, patients can work with their healthcare team to discuss the pros and cons of each and decide which one best meets their needs and preferences.
