Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis

Detalhes bibliográficos
Autor(a) principal: Cavalheiro, Ana
Data de Publicação: 2021
Outros Autores: Silva Cardoso, José, Rocha, Afonso, Moreira, Emília, Azevedo, Luís Filipe
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.16/2876
Resumo: Background: Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the management of chronic HF patients, compared to standard of care and standard rehabilitation (CBCR). Methods and results: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect and safety of TR programs in HF patients, regarding cardiovascular death, heart failure-related hospitalizations, functional capacity and quality of life. We searched 4 electronic databases up until May 2020, reviewed references of relevant articles and contacted experts. A quantitative synthesis of evidence was performed by means of random-effects meta-analyses. We included 17 primary studies, comprising 2206 patients. Four studies reported the number of hospitalizations (TR: 301; Control: 347). TR showed to be effective in the improvement of HF patients' functional capacity in the 6 Minute Walk-Test (Mean Difference (MD) 15.86; CI 95% [7.23; 24.49]; I2 = 74%) and in peak oxygen uptake (pVO2) results (MD 1.85; CI 95% [0.16; 3.53]; I2 = 93%). It also improved patients' quality of life (Minnesota Living with Heart Failure Questionnaire: MD -6.62; CI 95% [-11.40; -1.84]; I2 = 99%). No major adverse events were reported during TR exercise. Conclusion: TR showed to be superior than UC without CR on functional capacity improvement in HF patients. There is still scarce evidence of TR impact on hospitalization and cv death reduction. Further research and more standardized protocols are needed to improve evidence on TR effectiveness, safety and cost-effectiveness.
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spelling Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysisTele-rehabilitationfunctional capacityheart failurehospitalizationsquality of lifeBackground: Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the management of chronic HF patients, compared to standard of care and standard rehabilitation (CBCR). Methods and results: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect and safety of TR programs in HF patients, regarding cardiovascular death, heart failure-related hospitalizations, functional capacity and quality of life. We searched 4 electronic databases up until May 2020, reviewed references of relevant articles and contacted experts. A quantitative synthesis of evidence was performed by means of random-effects meta-analyses. We included 17 primary studies, comprising 2206 patients. Four studies reported the number of hospitalizations (TR: 301; Control: 347). TR showed to be effective in the improvement of HF patients' functional capacity in the 6 Minute Walk-Test (Mean Difference (MD) 15.86; CI 95% [7.23; 24.49]; I2 = 74%) and in peak oxygen uptake (pVO2) results (MD 1.85; CI 95% [0.16; 3.53]; I2 = 93%). It also improved patients' quality of life (Minnesota Living with Heart Failure Questionnaire: MD -6.62; CI 95% [-11.40; -1.84]; I2 = 99%). No major adverse events were reported during TR exercise. Conclusion: TR showed to be superior than UC without CR on functional capacity improvement in HF patients. There is still scarce evidence of TR impact on hospitalization and cv death reduction. Further research and more standardized protocols are needed to improve evidence on TR effectiveness, safety and cost-effectiveness.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article was supported by NORTE-01-0145-FEDER-032069 – “AdHeart – Engage with your heart”, financed by NORTE2020 under PORTUGAL2020; Project - NORTE-01-0145-FEDER-000026 – “Symbiotic technology for societal efficiency gains: Deus ex Machina”, financed by NORTE2020 under PORTUGAL2020; National Funds through FCT - Fundação para a Ciência e a Tecnologia, I.P., within CINTESIS, R&D Unit (reference UIDB/4255/2020).SAGE PublicationsRepositório Científico do Centro Hospitalar Universitário de Santo AntónioCavalheiro, AnaSilva Cardoso, JoséRocha, AfonsoMoreira, EmíliaAzevedo, Luís Filipe2023-10-31T13:29:25Z2021-062021-06-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2876engCavalheiro AH, Silva Cardoso J, Rocha A, Moreira E, Azevedo LF. Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis. Health Serv Insights. 2021;14:11786329211021668. doi:10.1177/117863292110216681178-632910.1177/11786329211021668info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-11-02T05:59:45Zoai:repositorio.chporto.pt:10400.16/2876Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:26:28.812275Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
title Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
spellingShingle Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
Cavalheiro, Ana
Tele-rehabilitation
functional capacity
heart failure
hospitalizations
quality of life
title_short Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
title_full Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
title_fullStr Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
title_full_unstemmed Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
title_sort Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis
author Cavalheiro, Ana
author_facet Cavalheiro, Ana
Silva Cardoso, José
Rocha, Afonso
Moreira, Emília
Azevedo, Luís Filipe
author_role author
author2 Silva Cardoso, José
Rocha, Afonso
Moreira, Emília
Azevedo, Luís Filipe
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Repositório Científico do Centro Hospitalar Universitário de Santo António
dc.contributor.author.fl_str_mv Cavalheiro, Ana
Silva Cardoso, José
Rocha, Afonso
Moreira, Emília
Azevedo, Luís Filipe
dc.subject.por.fl_str_mv Tele-rehabilitation
functional capacity
heart failure
hospitalizations
quality of life
topic Tele-rehabilitation
functional capacity
heart failure
hospitalizations
quality of life
description Background: Tele-rehabilitation (TR) may be an effective alternative or complement to centre-based cardiac rehabilitation (CBCR) with heart failure (HF) patients, helping overcome accessibility problems to CBCR. The aim of this study is to systematically review the literature in order to assess the clinical effectiveness of TR programs in the management of chronic HF patients, compared to standard of care and standard rehabilitation (CBCR). Methods and results: We conducted a systematic review and meta-analysis of randomized controlled trials on the effect and safety of TR programs in HF patients, regarding cardiovascular death, heart failure-related hospitalizations, functional capacity and quality of life. We searched 4 electronic databases up until May 2020, reviewed references of relevant articles and contacted experts. A quantitative synthesis of evidence was performed by means of random-effects meta-analyses. We included 17 primary studies, comprising 2206 patients. Four studies reported the number of hospitalizations (TR: 301; Control: 347). TR showed to be effective in the improvement of HF patients' functional capacity in the 6 Minute Walk-Test (Mean Difference (MD) 15.86; CI 95% [7.23; 24.49]; I2 = 74%) and in peak oxygen uptake (pVO2) results (MD 1.85; CI 95% [0.16; 3.53]; I2 = 93%). It also improved patients' quality of life (Minnesota Living with Heart Failure Questionnaire: MD -6.62; CI 95% [-11.40; -1.84]; I2 = 99%). No major adverse events were reported during TR exercise. Conclusion: TR showed to be superior than UC without CR on functional capacity improvement in HF patients. There is still scarce evidence of TR impact on hospitalization and cv death reduction. Further research and more standardized protocols are needed to improve evidence on TR effectiveness, safety and cost-effectiveness.
publishDate 2021
dc.date.none.fl_str_mv 2021-06
2021-06-01T00:00:00Z
2023-10-31T13:29:25Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.16/2876
url http://hdl.handle.net/10400.16/2876
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Cavalheiro AH, Silva Cardoso J, Rocha A, Moreira E, Azevedo LF. Effectiveness of Tele-rehabilitation Programs in Heart Failure: A Systematic Review and Meta-analysis. Health Serv Insights. 2021;14:11786329211021668. doi:10.1177/11786329211021668
1178-6329
10.1177/11786329211021668
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv SAGE Publications
publisher.none.fl_str_mv SAGE Publications
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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