Clinical and cost-effectiveness of home-based cardiac rehabilitation compared to conventional, centre-based cardiac rehabilitation: Results of the FIT@Home study

Jos J. Kraal, M. Elske Van Den Akker-Van Marle, Ameen Abu-Hanna, Wim Stut, Niels Peek, Hareld M.C. Kemps

Research output: Contribution to journalArticleAcademicpeer-review

64 Citations (Scopus)

Abstract

Aim Although cardiac rehabilitation improves physical fitness after a cardiac event, many eligible patients do not participate in cardiac rehabilitation and the beneficial effects of cardiac rehabilitation are often not maintained over time. Home-based training with telemonitoring guidance could improve participation rates and enhance long-term effectiveness. Methods and results We randomised 90 low-to-moderate cardiac risk patients entering cardiac rehabilitation to three months of either home-based training with telemonitoring guidance or centre-based training. Although training adherence was similar between groups, satisfaction was higher in the home-based group (p = 0.02). Physical fitness improved at discharge (p < 0.01) and at one-year follow-up (p < 0.01) in both groups, without differences between groups (home-based p = 0.31 and centre-based p = 0.87). Physical activity levels did not change during the one-year study period (centre-based p = 0.38, home-based p = 0.80). Healthcare costs were statistically non-significantly lower in the home-based group (€437 per patient, 95% confidence interval -562 to 1436, p = 0.39). From a societal perspective, a statistically non-significant difference of €3160 per patient in favour of the home-based group was found (95% confidence interval -460 to 6780, p = 0.09) and the probability that it was more cost-effective varied between 97% and 75% (willingness-to-pay of €0 and €100,000 per quality-adjusted life-years, respectively). Conclusion We found no differences between home-based training with telemonitoring guidance and centre-based training on physical fitness, physical activity level or health-related quality of life. However, home-based training was associated with a higher patient satisfaction and appears to be more cost-effective than centre-based training. We conclude that home-based training with telemonitoring guidance can be used as an alternative to centre-based training for low-to-moderate cardiac risk patients entering cardiac rehabilitation.

Original languageEnglish
Pages (from-to)1260-1273
Number of pages14
JournalEuropean Journal of Preventive Cardiology
Volume24
Issue number12
DOIs
Publication statusPublished - 1 Aug 2017
Externally publishedYes

Keywords

  • Cardiac rehabilitation
  • home-based training
  • physical activity
  • physical fitness
  • telemonitoring

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