Journal article
Feasibility and Effectiveness of Remote, Telephone-Based Delivery of Cardiac Rehabilitation
Telemedicine journal and e-health, Vol.20(1), pp.32-38
01/01/2014
DOI: 10.1089/tmj.2013.0079
PMCID: PMC3880057
PMID: 24161003
Abstract
Objectives:
Cardiac rehabilitation (CR) provides significant benefit for persons with cardiovascular disease. However, access to CR services may be limited by driving distance, costs, need for a driver, time away from work, or being a family primary caregiver. The primary aim of the project was to test the reach (i.e., patient and provider uptake), effectiveness (safety and clinical outcomes), and implementation (time and costs) of a remote telephone-based Phase 2 CR program. A secondary aim was to compare outcomes between patients attending the remote program (home-CR) and those attending an on-site program (comparison group).
Subjects and Methods:
Subjects were given a choice of the remote or face-to-face program. Remote CR participants (
n
=48) received education and assessment during 12 weekly by telephone calls. Data were compared with those for face-to-face CR program participants (
n
=14). Independent
t
tests and chi-squared tests were used for continuous and categorical variables, respectively. Repeated-measures analysis of covariance models were used to assess differences in outcomes. Costs were analyzed using a cost-minimization analysis.
Results:
Of 107 eligible patients, 45 refused participation, 5 dropped out, and 1 died unrelated to the study. Participants had a mean age of 64 (standard deviation 7.5) years. Remote CR participants were highly satisfied with their care and had a higher completion rate (89% of authorized sessions versus 73% of face-to-face). Costs for each program were comparable. There were no significant changes over time in any measured outcome between groups at 12 weeks except medication adherence, which decreased over time in both groups; face-to-face patients reported a greater decrease (
p
=0.05).
Conclusions:
This is the first study to test a remote CR program in a population of older Veterans. Many hospitals do not provide comprehensive CR services on-site; thus remote CR is a viable alternative to bring services closer to the patient.
Details
- Title: Subtitle
- Feasibility and Effectiveness of Remote, Telephone-Based Delivery of Cardiac Rehabilitation
- Creators
- Bonnie Wakefield - 2The Comprehensive Access and Delivery Research and Evaluation Center at the Iowa City VA Healthcare System, Iowa City, IowaKariann Drwal - 2The Comprehensive Access and Delivery Research and Evaluation Center at the Iowa City VA Healthcare System, Iowa City, IowaMelody Scherubel - 2The Comprehensive Access and Delivery Research and Evaluation Center at the Iowa City VA Healthcare System, Iowa City, IowaThomas Klobucar - 3Office of Rural Health, Veterans Health Administration, Washington, D.CSkyler Johnson - 2The Comprehensive Access and Delivery Research and Evaluation Center at the Iowa City VA Healthcare System, Iowa City, IowaPeter Kaboli - 4Division of General Internal Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- Telemedicine journal and e-health, Vol.20(1), pp.32-38
- DOI
- 10.1089/tmj.2013.0079
- PMID
- 24161003
- PMCID
- PMC3880057
- NLM abbreviation
- Telemed J E Health
- ISSN
- 1530-5627
- eISSN
- 1556-3669
- Publisher
- Mary Ann Liebert, Inc
- Language
- English
- Date published
- 01/01/2014
- Academic Unit
- Epidemiology; Internal Medicine
- Record Identifier
- 9984094391502771
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