Remote cardiac rehabilitation (RCR) represents a promising, noninferior alternative to facility-based cardiac rehabilitation (FBCR). The comparable cost of RCR in US populations has yet to be extensively studied. The purpose of this prospective, patient-selected study of traditional FBCR versus a third-party asynchronous RCR platform was to assess whether RCR can be administered at a comparable cost and clinical efficacy to FBCR. Adult insured patients were eligible for enrollment after an admission for a coronary heart disease event. Patients selected either FBCR or Movn RCR, a 12-week telehealth intervention using an app-based platform and internet-capable medical devices. Clinical demographics, intervention adherence, cost-effectiveness, and hospitalizations at 1-year after enrollment were assessed from the Highmark claims database after propensity matching between groups. A total of 260 patients were included and 171 of those eligible (65.8%) received at least 1 cardiac rehabilitation session and half of the patients chose Movn RCR. The propensity matching produced a sample of 41 matched pairs. Movn RCR led to a faster enrollment and higher completion rates (80% vs 50%). The total medical costs were similar between Movn RCR and FBCR, although tended toward cost savings with Movn RCR ($10,574/patient). The cost of cardiac rehabilitation was lower in those enrolled in Movn RCR ($1,377/patient, p = 0.002). The all-cause and cardiovascular-related hospitalizations or emergency department visits in the year after enrollment in both groups were similar. In conclusion, this pragmatic study of patients after a coronary heart disease event led to equivalent total medical costs and lower intervention costs for an asynchronous RCR platform than traditional FBCR while maintaining similar clinically important outcomes.
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http://dx.doi.org/10.1016/j.amjcard.2023.08.061 | DOI Listing |
Front Public Health
January 2025
Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Objectives: This study aimed to systematically develop a nurse-led complex intervention to enhance the quality of and adherence to home-based cardiac rehabilitation (HBCR) care for patients who have undergone transcatheter aortic valve replacement (TAVR). The intervention integrated stakeholder perspectives, expert insights, empirical evidence, and theoretical frameworks.
Methods: We initially searched for initial cardiac rehabilitation strategies based on the "Behavior Change Wheel" model and literature review.
Kardiol Pol
January 2025
Department of Electrocardiology and Heart Failure, Medical University of Silesia in Katowice, Katowice, Poland.
Background: Sleep-disordered breathing (SDB) impairs exercise capacity after myocardial infarction (MI).
Aims: This study aimed to evaluate the impact of SDB on the efficacy of post-MI cardiac rehabilitation (CR).
Methods: The study evaluated consecutive patients up to 28 days after MI who participated in outpatient CR as part of the Polish Managed Care after Acute Myocardial Infarction program.
Kardiol Pol
January 2025
National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Republic of Ireland.
Kardiol Pol
January 2025
Institute of Heart Diseases, Medical University and University Hospital, Wroclaw, Poland.
Kardiol Pol
January 2025
Department of Cardiac Surgery and Transplantology, National Medical Institute, Ministry of Interior and Administration, Center of Postgraduate Medical Education, Warszawa, Poland.
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