Home-based or Centre Based Chronic Heart Failure Rehabilitation?

Miss Katie Palmer1,2, Mrs Carla Gordon1,2, Miss Zoey Hoi Man  Wu1, Miss Hiu Yan Hilary  Yu1, Miss Phoebe Kwok1

1Monash University, Frankston, Australia, 2Monash Health, Melbourne, Australia

Abstract:

Background:
Chronic Heart Failure (CHF) is a rising epidemic with a high global economic cost. In Australia the prevalence is currently 2% of the population, with over 600,000 new cases expected by 2025 (Chen, 2017). Rehabilitation has been shown to be effective in improving patient and economic outcomes, yet reported engagement rates have been low world-wide (Sagar, 2015). It has been suggested that home-based rehabilitation may remove some barriers to attendance including transportation and time flexibility, but there is limited evidence on the effectiveness of home-based programs (Palmer, 2018).

Objectives:
To investigate the effect of home-based rehabilitation for people living with CHF on quality of life, physical function, mortality and hospital re-admission rates. .

Methods:
Six electronic health-related database were searched. Two reviewers completed the screening process, data extraction and quality assessment. Articles were included if they involved a home-based exercise program in the CHF population

Results:
Eleven articles were included of the 919 identified (n=633, mean age 63yrs, 79% male). Home-based rehabilitation was found to significantly improve physical function (SMD 0.42, 95%CI 0.12-0.73, p=0.007) and quality of life (SMD 0.49, 95% CI 0.02-0.96, p=0.000) over usual care. None of the included studies included outcome measures on mortality and hospital re-admission rates.

Conclusion:
Home-based rehabilitation is effective in improving physical function and quality of life more than usual care in the CHF population. These findings support the provision of home-based programs as an evidence-based alternative for CHF patients and may help to improve engagement and adherence with CHF rehabilitation.

Biography:

Katie Palmer is currently completing a PhD at Monash University in Melbourne, Victoria in the School of Primary and Allied Health Care. Her research is focused on improving engagement of people with Chronic Heart Failure with rehabilitation programs, by identifying and addressing the barriers this population faces.

Her passion for this research project stems from her current work as the physiotherapist for the Chronic Heart Failure rehabilitation program at Monash Health.