Nav: Home

Home-based cardiac rehabilitation is an option to overcome barriers of traditional cardiac rehabilitation

May 13, 2019

DALLAS, May 13, 2019 -- Home based, medically supervised cardiac rehabilitation may be, for some patients, an alternative to traditional medical center cardiac rehabilitation programs after a heart attack or other heart procedure, according to a joint scientific statement from the American Heart Association, American College of Cardiology and the American Association of Cardiovascular and Pulmonary Rehabilitation.

Traditional cardiac rehabilitation programs are provided in a medical center and are implemented by a team of physicians, nurses, psychologists, registered dieticians and other professionals. They help patients recover from heart attacks, bypass surgery, angioplasty, heart failure and other conditions through a program of exercise training, nutrition and psychological counseling tailored to each individual's needs. Cardiac rehabilitation has been proven effective at reducing the risk of subsequent heart attacks, improving quality of life and avoiding additional hospitalizations in addition to other benefits.

However, about 80% of U.S. patients who would benefit from cardiac rehabilitation do not participate, according to Randal J. Thomas, M.D., M.S., chair of the writing group for the statement published simultaneously in the American Heart Association journal Circulation, the Journal of the American College of Cardiology and the Journal of Cardiopulmonary Rehabilitation and Prevention.

"There are significant barriers that prevent patients from getting the cardiac rehabilitation care that they need. And, there aren't enough programs in the United States to meet the needs of every patient that would benefit," said Thomas, a professor of medicine and medical director of the cardiac rehabilitation program at Mayo Clinic in Rochester, Minnesota. "There is an urgent need to find new ways of delivering cardiac rehabilitation programs to patients. Home-based care is an excellent option for some patients who aren't able to attend a center-based program."

The statement presents a framework for home-based cardiac rehabilitation programs that helps ensure patients get scientifically-based, standardized care, Thomas said.

"A home-based cardiac rehabilitation program is much more than advising a patient to exercise at home," he said. "For patients whose heart disease is stable, home-based cardiac rehabilitation is administered and monitored in the same way and by the same health care team as with medical center-based cardiac rehabilitation. The difference is that supervision and coaching are done remotely, using smart phones or other technology."

Thomas said that for a program done in the home to be effective, health care providers should ensure patients are on the right medications and are improving exercise and nutrition habits. In addition, psychological health, medical conditions linked to heart disease, such as diabetes, high blood pressure and high cholesterol, as well as risk factors for heart disease such as tobacco smoking should be addressed. Patients should also be monitored for any heart disease symptoms or for side effects of medications. "All of these components should be in place with a high-quality home-based program - if they are not, patients could be receiving less care than they need," Thomas said.

Heart attack, heart bypass and other heart patients should talk with their health care providers about their rehabilitation options - whether those are center-based, home-based or a mix of the two.

"Unfortunately, cardiac rehabilitation in the home-based setting is generally not covered by most insurance carriers, including Medicare. As more evidence accumulates to support home-based cardiac rehabilitation and the technology advances to make this more feasible, we need to work together with policymakers to find ways for these services to be covered" Thomas said.

Health care systems in the United Kingdom, Canada and other countries successfully offer home-based cardiac rehabilitation, but most U.S. health care organizations have little experience with the home-based option.

Researchers have shown that in many patients with stable heart disease home-based cardiac rehabilitation can achieve results similar to medical center-based cardiac rehabilitation in the months and years following heart attacks or other cardiac procedures. What isn't as clear is how home-based care compares with center-delivered cardiac rehabilitation for higher-risk cardiac patients, the elderly, women and some understudied minority groups, according to Thomas.
-end-
Co-authors include: vice-chair of the writing group Mary A. Whooley, M.D.; Alexis L. Beatty, M.D., M.A.S.; Theresa M. Beckie, Ph.D., M.S.N.; LaPrincess C. Brewer, M.D., M.P.H.; Todd M. Brown, M.D.; Daniel E. Forman, M.D., Barry A. Franklin, Ph.D..; Steven J. Keteyian, Ph.D.; Dalane W. Kitzman, M.D.; Judith G. Regensteiner, Ph.D.; and Bonnie K. Sanderson, Ph.D., R.N. Author disclosures are on the manuscript.

The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

About the American College of Cardiology

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its more than 52,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit acc.org.

About the American Association of Cardiovascular and Pulmonary Rehabilitation

Founded in 1985, the American Association of Cardiovascular and Pulmonary Rehabilitation is a multidisciplinary organization dedicated to the mission of reducing morbidity, mortality and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research and disease management. Central to the core mission is improvement in quality of life for patients and their families. AACVPR publishes a number of key documents dedicated to advancing the quality of cardiovascular and pulmonary rehabilitation and secondary prevention programs and publishes the Journal of Cardiopulmonary Rehabilitation and Prevention. Learn more about AACVPR at http://www.aacvpr.org.

American Heart Association

Related Heart Disease Articles:

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.
Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.
Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.
New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.
Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.
Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.
Women once considered low risk for heart disease show evidence of previous heart attack scars
Women who complain about chest pain often are reassured by their doctors that there is no reason to worry because their angiograms show that the women don't have blockages in the major heart arteries, a primary cause of heart attacks in men.
Where you live could determine risk of heart attack, stroke or dying of heart disease
People living in parts of Ontario with better access to preventive health care had lower rates of cardiac events compared to residents of regions with less access, found a new study published in CMAJ (Canadian Medical Association Journal).
Older adults with heart disease can become more independent and heart healthy with physical activity
Improving physical function among older adults with heart disease helps heart health and even the oldest have a better quality of life and greater independence.
Dietary factors associated with substantial proportion of deaths from heart disease, stroke, and disease
Nearly half of all deaths due to heart disease, stroke, and type 2 diabetes in the US in 2012 were associated with suboptimal consumption of certain dietary factors, according to a study appearing in the March 7 issue of JAMA.
More Heart Disease News and Heart Disease Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Reinvention
Change is hard, but it's also an opportunity to discover and reimagine what you thought you knew. From our economy, to music, to even ourselves–this hour TED speakers explore the power of reinvention. Guests include OK Go lead singer Damian Kulash Jr., former college gymnastics coach Valorie Kondos Field, Stockton Mayor Michael Tubbs, and entrepreneur Nick Hanauer.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.