How much do the benefits cost? Effects of a home-based training programme on cardiovascular fitness, quality of life, programme cost and adherence for patients with coronary disease.Clin Rehabil. 2008 Oct-Nov; 22(10-11):987-96.CR
To evaluate cost, adherence and effects on cardiovascular function and quality of life of a home-based cardiac rehabilitation programme for patients with coronary disease.
A randomized, prospective controlled trial.
Department of Rehabilitation, University Hospital, Brazil.
Thirty-nine low-risk patients were assigned to a home exercise training group (n = 19) or a control group (n = 20).
The home group performed home-based training for three months with biweekly telephone monitoring.
MAIN OUTCOME MEASURES
The aerobic capacity and the quality of life (Medical Outcomes Study 36-Item Short Form Survey (SF-36)) of all patients were evaluated before and after the three-month period. Adherence was evaluated weekly. Programme cost was estimated using the Brazilian Classification of Medical Procedures.
After training, the home group had higher peak Vo2 from 28.8 (6.4) to 31.7 (8.1) mL/kg per minute, peak heart rate from 135 (22) to 143 (20) bpm, work rate from 4780 (2021) to 7103 (3057) kpm/min and exercise time from 11.5 (1.9) to 13.6 (2.3) minutes (P < or = .05). The control group showed reduction in peak Vo2 from 28.6 (6.6) to 26.8 (7.2) mL/kg per minute, peak Vo2 pulse from 15.5 (3.9) to 14.3 (3.8) mL/bpm and exercise time from 11.5 (2.3) to 11.4 (2.7) minutes (P < or = 0.05). The home group reported improvements in all domains of SF-36. The control group showed improvement in only three domains of SF-36. In the home group the average cost per patient was US$502.71 and the adherence achieved 100%.
The programme seems to provide an efficient low-cost approach to cardiac rehabilitation in low-risk patients.