Дистанционная кардиореабилитация не повысила участие пациентов после инфаркта

Remote option does not increase participation in cardiac rehabilitation after heart attack Key takeaways: - The option to use a remote exercise-based program did not increase participation in cardiac rehabilitation after heart attack. - The results were similar between center-based and remote programs. MUNICH — Remote exercise-based cardiac rehabilitation did not increase participation compared with center-based cardiac rehab in patients with heart attack, according to findings presented at the European Society of Cardiology Congress. However, patients with the option to use a remote exercise-based program had just as much improvement in physical capacity as those who had to use a center-based program only, according to the results of the Remote Exercise SWEDEHEART study. “Exercise as part of cardiac rehabilitation supports recovery and improves better long-term health after a heart attack. Yet only around 15% of eligible patients complete supervised center-based exercise programs,” Maria Bäck, PhD, FESC, from Sahlgrenska University Hospital and University of Gothenburg, Sweden, said during a press conference. “And therefore, we thought that remotely delivered exercise may improve access by allowing patients to exercise at home with a real-time support from a physiotherapist. Previous studies within this field are quite small, single-center [randomized controlled] studies. But whether this approach works at scale as part of routine healthcare has remained unclear.” Bäck and colleagues conducted a cluster randomized trial of 23 Swedish centers that offered cardiac rehab programs to 3,112 patients recovering from MI (mean age, 66 years; 25% women). Centers were assigned to center-based rehabilitation only or an intervention in which patients could choose between remotely delivered exercise, center-based exercise or a combination of both, Bäck said. After 15 months, the centers crossed over to the other option, and the study continued for another 15 months. When the remote option was available, 38% of sessions were performed remotely, Bäck said during the press conference. Physical capacity improved by 11% in both groups and there were few serious exercise-related adverse events (center-based exercise, 0.47 per 1,000 patient-hours; remote exercise, 0.17 per 1,000 patient-hours), Bäck said. There was no difference between the groups in mean number of completed exercise sessions, nor in the percentage of participants who completed the full exercise program (intervention period, 13.8%; control period, 13.6%), she said. “The take-home message is that remote exercise should be viewed as an additional patient-centered option within cardiac rehabilitation, but not as a standalone solution to low participation rates,” Bäck said during the press conference. “Remotely delivered exercise was indeed used when available. It produced similar improvements in physical capacity, and it was associated with few serious exercise-related adverse events. But it did not increase overall participation. Therefore, cardiac telerehabilitation can be viewed as a more personalized form of cardiac rehabilitation, including the option to exercise remotely from home, which may better meet individual patient needs and preferences.” Quality of life data were collected and will be reported later, she said.