Evaluating the Effectiveness of Home based versus Comprehensive Cardiac Rehabilitation on Mortality in Myocardial Infarction Survivors.

Abstract

Background: Myocardial infarction (MI) is a health concern with different mortality rates even with advanced treatment. Home care is a new approach for monitoring and providing care to MI patients after discharge. This study aimed to evaluate the effectiveness of home based versus comprehensive cardiac rehabilitation recommendations on mortality among MI survivors.

Method: This randomized clinical trial at Cardiac Rehabilitation Research Center, Isfahan, involved myocardial infarction survivors. Participants were divided into intervention (home based CR) and control (comprehensive CR) groups with a block randomization method. Mortality, returning to work, and rehospitalization rates of both groups were assessed and compared at 6, 12, and 60 months after MI.

Results: Totally 259 participants were included in this study. Baseline variables were relatively similar in both groups. The odds of death in home care were 45% less than the control group (OR = 0.55, 95% CI: 0.21 - 1.45, P = 0.229), and the odds of death changed 1,09 times by increasing each year of patients (OR = 1.09, 95% CI: 1.01 - 1.18, P = 0.027). Also, returning to work was significantly higher in the intervention group during the 0-6-month period (intervention group = 99.08% vs. control group = 92.31% P = 0.032).

Conclusions: The study found a 45% lower risk of death in the home based group, which was not statistically significant, possibly due to sample size limitations. However, the rate of returning to work activity was higher in the home based CR group. The home based method can be chosen as an alternative to comprehensive CR based on decision-making with the patient, specialists, and caregivers.