Alternative models of cardiac rehabilitation : a systematic review

Clark, Robyn, Conway, Aaron, Poulsen, Vanessa, Keech, Wendy, Tirimacco, Rosy, & Tideman, Phillip (2015) Alternative models of cardiac rehabilitation : a systematic review. European Journal of Preventive Cardiology, 22(1), pp. 35-74.

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Abstract

The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or home-based, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences.

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31 citations in Web of Science®

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ID Code: 61496
Item Type: Journal Article
Refereed: Yes
Additional Information: European Society of Cardiology, European Association for Cardiovascular Prevention and Rehabilitation
Keywords: Cardiovascular diseases, coronary disease, acute coronary syndrome, myocardial infarction, cardiac rehabilitation, systematic review, risk factors, telemedicine, internet
DOI: 10.1177/2047487313501093
ISSN: 2047-4881
Subjects: Australian and New Zealand Standard Research Classification > TECHNOLOGY (100000) > OTHER TECHNOLOGY (109900)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CARDIOVASCULAR MEDICINE AND HAEMATOLOGY (110200)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2015 The Authors & SAGE Publications
Deposited On: 22 Jul 2013 22:21
Last Modified: 17 Jul 2015 10:34

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