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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 HF and CAD patients.25,27”
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2023 ESC Guidelines for the management of acute coronary syndromes
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2023 ESC Guidelines for the management of acute coronary syndromes
Byrne, R. A., Rosselló, X., Coughlan, J. J., Barbato, E., Berry, C., Chieffo, A., Claeys, M. J., Dan, G., Dweck, M. R., Galbraith, M., et al. (2023) · European Heart Journal Acute Cardiovascular Care · doi:10.1093/ehjacc/zuad107 · Cited by 373
Metadata
- 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 › Physiology (medical) › 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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