Efficacy of home-based versus centre-based cardiac rehabilitation in an Indian cardiovascular disease population. (25th January 2023)

• Record Type: Journal Article
• Authors: Chockalingam, P; Shobika, J; Rajeswari, S; Anantharaman, R; Yusuf, M M; Sengottuvelu, G; Chockalingam, V
• Is Part Of: European heart journal. Volume 44(2023)Supplement 1
• Publication Date: 2023-01-25
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehac779.109
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Funding Acknowledgements: Type of funding sources: None. Background: Cardiac rehabilitation (CR), an integral component of cardiovascular disease (CVD) management in developed countries, is yet to become mainstream in India. With the prevailing gross mismatch between the need and the availability of CR services, an alternative model such as home-based CR may be the potential solution to challenges such as accessibility issues, transportation cost and lack of time. Purpose: This study aimed to compare the efficacy of home-based versus centre-based CR in an Indian CVD population. Methods: All CVD patients who participated in our centre-based and home-based CR programs between mid-2014 and mid-2022 were included in the study. Subjects who did not complete their post program evaluation (n=15) were excluded. Demographic data and data pertaining to CVD risk factors, nature of CVD, procedure undergone and details of CR program provided were documented for all subjects. A multidisciplinary team consisting of Physician, Physiotherapist, Dietician, and Counseling Psychologist provided the CR program in-person or using telehealth platforms for the centre-based and home-based programs respectively. Subjects who attended some in-person and some home-based sessions were categorized based on the nature of the majority sessions. Results: Age of the subjects (n=106) was 60±13 years, 94 (89%) were male and 22 (21%) were residing outside Chennai. While the risk factor and disease profiles were comparable, the home-based group was younger, had more out of Chennai participants and attended more sessions over a longer duration compared to the centre-based group (Table 1). The higher number of hybrid revascularization procedures in the home-based group corroborates with this being the preferred modality for acute coronary syndrome management during the pandemic-led lockdown. There was a significant improvement in body mass index, systolic blood pressure, 6-minute walk distance and left ventricular ejection fraction in those who completed the centre-based as well as home-based CR programs (Table 2). Conclusions: Home-based CR is as efficacious as centre-based CR, is easier to deploy and helps overcome challenges inherent to centre-based CR such as transportation and time constraints. Home-based CR has potential to become the main mode of CR delivery in low-resource settings in the future.