Home-Based Cardiac Rehabilitation Among Attendees From a Large Health Care System During the Covid-19 Pandemic

Background: Few studies have evaluated home-based cardiac rehabilitation (HBCR) during the pandemic, compared to prepandemic center-based CR (CBCR), with respect to patient characteristics, participation rates, and its efficacy on clinical metrics, health-related quality of life (QoL), and modifiable risk factors.

Objectives: We aimed to describe patient characteristics and participation rates for those attending HBCR compared to patients who attended CBCR and compare the effects of HBCR vs CBCR on clinical metrics, health-related QoL, and modifiable risk factors in CR patients pre vs during the COVID-19 pandemic.

Methods: A retrospective cohort study comparing 511 HBCR patients and 765 CBCR patients from the Mayo Clinic Health System. HBCR included 12 sessions. Conventional CBCR included 36 sessions. Clinical outcomes before and after CR were assessed.

Results: The HBCR group demonstrated a smaller proportion of patients referred for coronary artery diseases (45.2% vs 63.3%) than the CBCR group (P < 0.001). The HBCR group participated in 74.5 ± 28.6% of prescribed sessions compared to 67.9% ± 35.7% of prescribed sessions in the CBCR group (P = 0.26). Both groups demonstrated similar improvements in nutrition, depression, QoL, glucose intolerance, and lipid profiles.

Conclusions: Patients participating in HBCR during the COVID-19 pandemic demonstrated similar participation rates compared to CBCR. HBCR appears to be similarly effective at improving several intermediate outcomes compared to CBCR. HBCR may be a suitable alternative CR delivery model to increase CR participation for a wide range of clinical indications and improve clinical outcomes in patients who are unable to participate in CBCR.