Article

The traditional hospital-based model of cardiac rehabilitation faces substantial
challenges, such as cost and accessibility. These challenges have led to the
development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of
these alternative models. A total of 22 databases were searched to identify
quantitative studies or systematic reviews of quantitative studies regarding the
effectiveness of alternative models of cardiac rehabilitation. Included studies
were appraised using a Critical Appraisal Skills Programme tool and the National
Health and Medical Research Council's designations for Level of Evidence. The 83
included articles described interventions in the following broad categories of
alternative models of care: multifactorial individualized telehealth, internet
based, telehealth focused on exercise, telehealth focused on recovery, community-
or home-based, and complementary therapies. Multifactorial individualized
telehealth and community- or home-based cardiac rehabilitation are effective
alternative models of cardiac rehabilitation, as they have produced similar
reductions in cardiovascular disease risk factors compared with hospital-based
programmes. While further research is required to address the paucity of data
available regarding the effectiveness of alternative models of cardiac
rehabilitation in rural, remote, and culturally and linguistically diverse
populations, our review indicates there is no need to rely on hospital-based
strategies alone to deliver effective cardiac rehabilitation. Local healthcare
systems should strive to integrate alternative models of cardiac rehabilitation,
such as brief telehealth interventions tailored to individual's risk factor
profiles as well as community- or home-based programmes, in order to ensure there
are choices available for patients that best fit their needs, risk factor profile, and preferences.
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Langue : ANGLAIS