Home based cardiac rehabilitation

BMJ 2010; 340 doi: http://dx.doi.org/10.1136/bmj.b5510 (Published 20 January 2010) Cite this as: BMJ 2010;340:b5510
  1. Alexander M Clark, associate professor
  1. 1Faculty of Nursing, University of Alberta, Edmonton, AB, Canada T6G 2G3
  1. alex.clark{at}ualberta.ca

    An effective way of widening access to preventative services

    In the linked systematic review (doi:10.1136/bmj.b5631), Dalal and colleagues assess the effect of home based cardiac rehabilitation on mortality and morbidity, health related quality of life, and modifiable cardiac risk factors in patients with coronary heart disease.1 They found that home based cardiac rehabilitation was as effective and efficient as centre based rehabilitation at reducing mortality and cardiac events; improving risk factors such as exercise capacity, systolic blood pressure, and total cholesterol; and increasing health related quality of life. This finding is consistent with another recent meta-analysis,2 which found that home based programmes provided by “telehealth” show promise in reducing mortality and can lead to clinically significant benefits in cholesterol, blood pressure, and prevalence of smoking.2 As with centre based programmes,3 4 a variety of home based programmes can improve health and quality of life outcomes in suitable patients.

    Providing programmes in the patient’s home makes sense because of what is needed for risk factor reduction. To improve morbidity and mortality, health behaviours must be sustained for at least two years.4 Home based programmes can provide support for these behaviours longer than …

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