Cardiac telerehabilitation: a novel cost-efficient care delivery strategy that can induce long-term health benefits
Abstract
Finding innovative and cost-efficient care strategies that induce long-term health benefits in cardiac patients constitutes a big challenge today. The aim of this Telerehab III follow-up study was to assess whether a 6-month additional cardiac telerehabilitation programme could induce long-term health benefits and remain cost-efficient after the tele-intervention ended. A total of 126 cardiac patients first completed the multicentre, randomised controlled telerehabilitation trial (Telerehab III, time points t0 to t1). They consequently entered the follow-up study (t1) with evaluations 2 years later (t2). A quantitative analysis of peak aerobic capacity (VO2 peak, primary endpoint), international physical activity questionnaire self-reported physical activity and HeartQoL quality of life (secondary endpoints) was performed. The incremental cost-effectiveness ratio was calculated. Even though a decline in VO2 peak (24 ± 8 ml/[min*kg] at t1 and 22 ± 6 ml/[min*kg] at t2; P ≤ 0.001) was observed within the tele-intervention group patients; overall they did better than the no tele-intervention group (P = 0.032). Dividing the incremental cost (−€878/patient) by the differential incremental quality-adjusted life years (QALYs) (0.22 QALYs) yielded an incremental cost-effectiveness ratio of –€3993/QALY. A combined telerehabilitation and centre-based programme, followed by transitional telerehabilitation induced persistent health benefits and remained cost-efficient up to 2 years after the end of the intervention. A partial decline of the benefits originally achieved did occur once the tele-intervention ended. Healthcare professionals should reflect on how innovative cost-efficient care models could be implemented in standard care. Future research should focus on key behaviour change techniques in technology-based interventions that enable full persistence of long-term behaviour change and health benefits. This study is registered in the ISRCTN registry (ISRCTN29243064).
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Only a few trials have investigated the effect of telerehabilitation on recurrent events, rehospitalisations and mortality in heart failure and coronary artery disease patients.
“Only a few trials have investigated the effect of telerehabilitation on recurrent events, rehospitalisations and mortality in HF and CAD patients.25,27”
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- Authors
- Frederix, I., Solmi, F., Piepoli, M. F., & Dendale, P.
- Affiliations
- University of Antwerp (BE)
- Hasselt University (BE)
- Azienda Unità Sanitaria Locale Piacenza (IT)
- Jessa Hospital (BE)
- Corresponding author
- Frederix, Ines
- Venue
- European Journal of Preventive Cardiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-09-19
- Volume
- 24
- Issue
- 16
- Pages
- 1708-1717
- ISSN
- 2047-4873 (ISSN-L)
- 2047-4881
- OpenAlex
- W2754554608
- Cited by
- 172
- References
- 17
- Citations by year
- 2026: 10 · 2025: 17 · 2024: 20 · 2023: 22 · 2022: 28 · 2021: 16 · 2020: 13 · 2019: 29 · 2018: 14 · 2017: 2
- FWCI
- 12.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Preventive Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Document Server@UHasselt (UHasselt) (submittedVersion)
- Funders
- Fonds Wetenschappelijk Onderzoek
- Virginia Agricultural Experiment Station, Virginia Polytechnic Institute and State University
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- cardiac telerehabilitation, cost-effectiveness, long-term health benefits, peak aerobic capacity, physical activity, quality of life, care transitions, behavior change, technology-based interventions, quality-adjusted life years
- MeSH terms
- Telerehabilitation, Cardiac Rehabilitation, Cost-Benefit Analysis, Female, Follow-Up Studies, Humans, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Time Factors, Practice Guidelines as Topic, Quality-Adjusted Life Years
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