Abstract
BACKGROUND: A variety of different types of secondary prevention programs for coronary heart disease (CHD) exist. Home-based programs have become more common and may be more accessible or preferable to some patients. This review compared the benefits and costs of home-based programs with usual care and cardiac rehabilitation. METHODS: A meta-analysis following a systematic search of 19 databases, existing reviews, and references was designed. Studies evaluated home-based interventions that addressed more than one main CHD risk factor using a randomized trial with a usual care or cardiac rehabilitation comparison group with data extractable for CHD patients only and reported in English as a full article or thesis. RESULTS: Thirty-nine articles reporting 36 trials were reviewed. Compared with usual care, home-based interventions significantly improved quality of life [weighted mean difference: 0.23; 95% confidence interval (95% CI): 0.02-0.45], systolic blood pressure (weighted mean difference: -4.36mmHg; 95% CI: -6.50 to -2.22), smoking cessation (difference in proportion: 14%; 95% CI: 0.02-0.26), total cholesterol (standardized mean difference: -0.33; 95% CI: -0.57 to -0.08), and depression (standardized mean difference: -0.33; 95% CI: -0.59 to -0.07). Effect sizes were small to moderate and trials were of low-to-moderate quality. Comparisons with cardiac rehabilitation could not be made because of the small number of trials and high levels of heterogeneity. CONCLUSION: Home-based secondary prevention programs for CHD are an effective and relatively low-cost complement to hospital-based cardiac rehabilitation and should be considered for stable patients less likely to access or adhere to hospital-based services.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 261-270 |
| Number of pages | 10 |
| Journal | European Journal of Cardiovascular Prevention and Rehabilitation |
| Volume | 17 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 2010 |
| Externally published | Yes |
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Keywords
- Cardiac rehabilitation
- Disease management
- Health behavior
- Health promotion
- Health services
- Secondary prevention
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Epidemiology
Cite this
A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease. / Clark, Alexander M.; Haykowsky, Mark; Kryworuchko, Jennifer; MacClure, Todd; Scott, Jess; DesMeules, Marie; Luo, Wei; Liang, Y.; McAlister, Finlay A.
In: European Journal of Cardiovascular Prevention and Rehabilitation, Vol. 17, No. 3, 06.2010, p. 261-270.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease
AU - Clark, Alexander M.
AU - Haykowsky, Mark
AU - Kryworuchko, Jennifer
AU - MacClure, Todd
AU - Scott, Jess
AU - DesMeules, Marie
AU - Luo, Wei
AU - Liang, Y.
AU - McAlister, Finlay A.
PY - 2010/6
Y1 - 2010/6
N2 - BACKGROUND: A variety of different types of secondary prevention programs for coronary heart disease (CHD) exist. Home-based programs have become more common and may be more accessible or preferable to some patients. This review compared the benefits and costs of home-based programs with usual care and cardiac rehabilitation. METHODS: A meta-analysis following a systematic search of 19 databases, existing reviews, and references was designed. Studies evaluated home-based interventions that addressed more than one main CHD risk factor using a randomized trial with a usual care or cardiac rehabilitation comparison group with data extractable for CHD patients only and reported in English as a full article or thesis. RESULTS: Thirty-nine articles reporting 36 trials were reviewed. Compared with usual care, home-based interventions significantly improved quality of life [weighted mean difference: 0.23; 95% confidence interval (95% CI): 0.02-0.45], systolic blood pressure (weighted mean difference: -4.36mmHg; 95% CI: -6.50 to -2.22), smoking cessation (difference in proportion: 14%; 95% CI: 0.02-0.26), total cholesterol (standardized mean difference: -0.33; 95% CI: -0.57 to -0.08), and depression (standardized mean difference: -0.33; 95% CI: -0.59 to -0.07). Effect sizes were small to moderate and trials were of low-to-moderate quality. Comparisons with cardiac rehabilitation could not be made because of the small number of trials and high levels of heterogeneity. CONCLUSION: Home-based secondary prevention programs for CHD are an effective and relatively low-cost complement to hospital-based cardiac rehabilitation and should be considered for stable patients less likely to access or adhere to hospital-based services.
AB - BACKGROUND: A variety of different types of secondary prevention programs for coronary heart disease (CHD) exist. Home-based programs have become more common and may be more accessible or preferable to some patients. This review compared the benefits and costs of home-based programs with usual care and cardiac rehabilitation. METHODS: A meta-analysis following a systematic search of 19 databases, existing reviews, and references was designed. Studies evaluated home-based interventions that addressed more than one main CHD risk factor using a randomized trial with a usual care or cardiac rehabilitation comparison group with data extractable for CHD patients only and reported in English as a full article or thesis. RESULTS: Thirty-nine articles reporting 36 trials were reviewed. Compared with usual care, home-based interventions significantly improved quality of life [weighted mean difference: 0.23; 95% confidence interval (95% CI): 0.02-0.45], systolic blood pressure (weighted mean difference: -4.36mmHg; 95% CI: -6.50 to -2.22), smoking cessation (difference in proportion: 14%; 95% CI: 0.02-0.26), total cholesterol (standardized mean difference: -0.33; 95% CI: -0.57 to -0.08), and depression (standardized mean difference: -0.33; 95% CI: -0.59 to -0.07). Effect sizes were small to moderate and trials were of low-to-moderate quality. Comparisons with cardiac rehabilitation could not be made because of the small number of trials and high levels of heterogeneity. CONCLUSION: Home-based secondary prevention programs for CHD are an effective and relatively low-cost complement to hospital-based cardiac rehabilitation and should be considered for stable patients less likely to access or adhere to hospital-based services.
KW - Cardiac rehabilitation
KW - Disease management
KW - Health behavior
KW - Health promotion
KW - Health services
KW - Secondary prevention
UR - http://www.scopus.com/inward/record.url?scp=77954027155&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77954027155&partnerID=8YFLogxK
U2 - 10.1097/HJR.0b013e32833090ef
DO - 10.1097/HJR.0b013e32833090ef
M3 - Article
C2 - 20560165
AN - SCOPUS:77954027155
VL - 17
SP - 261
EP - 270
JO - European Journal of Preventive Cardiology
JF - European Journal of Preventive Cardiology
SN - 2047-4873
IS - 3
ER -