Home based versus centre based cardiac rehabilitation: Cochrane systematic review and meta-analysis.

This Cochrane review was completed to compare the effect of home based and supervised centre based cardiac rehabilitation on mortality and morbidity, health related quality of life, and modifiable cardiac risk factors in patients with coronary heart disease. The review included publications from 2001 – January 2008. Twelve studies (1938 participants) were included. Most studies recruited patients with a low risk of further events after myocardial infarction or revascularisation. No difference was seen between home based and centre based cardiac rehabilitation in terms of mortality, cardiac events, exercise capacity, modifiable risk factors, total cholesterol, low density lipoprotein cholesterol, or relative risk for proportion of smokers at follow-up, or health related quality of life, with the exception of high density lipoprotein cholesterol. In the home based participants, there was evidence of superior adherence. No consistent difference was seen in the healthcare costs of the two forms of cardiac rehabilitation.

In conclusion home and centre based forms of cardiac rehabilitation seem to be equally effective in improving clinical and health related quality of life outcomes in patients with a low risk of further events after myocardial infarction or revascularisation.

Dalal HM, Zawada A, Jolly K, Moxham T, Taylor RS. BMJ 2010;340:b5631 (Free Full text)

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