At-home cardiac rehabilitation may lower risk of death: study

Veterans who participated in a home-based cardiac rehabilitation program had a 36 percent lower risk of mortality compared to people who opted out of the program, according to a study published in the Journal of the American Heart Association.

Patients in the study were hospitalized for a heart attack, coronary artery bypass grafting or other heart complications. Of the people who were offered home-based cardiac rehabilitation programs (HBCR), about 44 percent participated.

After an average follow-up period of about four years, the researchers found that the mortality rate was lower among the 490 HBCR participants compared to the 630 nonparticipants. 

The death rate one year after hospitalizations was 2 percent for HBCR participants, compared to 4 percent for nonparticipants. Overall, the mortality rate was 12 and 20 percent in HBCR participants and nonparticipants, respectively.

The HBCR program involved nine phone calls for coaching or motivational interviewing over 12 weeks to help patients adjust their behavior. Participants were also encouraged to document their vital signs, exercise and diet in a personal health journal.

These results support past research that similar on-site programs can lower risk of death. However, patients may be less likely to choose on-site rehabilitation compared to home-based rehabilitation. A 2020 study of Medicare patients found that 24 percent of eligible beneficiaries chose to participate in on-site cardiac rehabilitation.

“Whether in a hospital or home, cardiac rehabilitation is all about healthy behavior changes,” says senior study author Mary A. Whooley, who is a primary care physician at the San Francisco Veterans Affairs Medical Center and professor of medicine at the University of California, San Francisco, in a press release. “However, changing behaviors is difficult, and while care facilities may offer on-site cardiac rehabilitation, many patients don’t choose to take advantage of follow-up treatment. The biggest surprise of our analysis was how few patients chose to participate in cardiac rehabilitation.”