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Home-based cardiac rehabilitation to address evolving patient needs during the covid-19 pandemic
Journal of the Hong Kong College of Cardiology ; 28(2):90, 2020.
Article in English | EMBASE | ID: covidwho-1743904
ABSTRACT

Objectives:

Home-based cardiac rehabilitation (HBCR) and prevention programs (HBPP) which occupied a small proportion of the overall Preventive Cardiology work in the past have become mainstream during the COVID-19 pandemic. This study aims to analyse the design and delivery of HBCR/HBPP pre and during the pandemic to address evolving patient needs.

Methods:

All patients who had undergone HBCR/HBPP at our Preventive Cardiology centre in Chennai, India till 22 March 2020 (pre-pandemic enrolees) and from 23 March-10 September 2020 (during-pandemic enrolees) were included. Hybrid programs had some in-person and some online/phone sessions;completely home-based programs had only online/phone sessions. Intake evaluation consisted of physician consultation, review of medical records, health-related lifestyle questionnaire, quality of life questionnaire, 24-hour diet recall and body mass index and functional capacity (FC) assessment. The sixminute walk test (6MWT) or the 2-minute step test (2MST) was used for FC assessment. A multidisciplinary team consisting of Physician, Physiotherapist and Dietician provided 1-2 sessions per week for 3-6 months. HBCR was offered to low/medium risk patients.

Results:

Of the 29 subjects (57±13 years, 69% male), 16 (55%) were prepandemic enrolees and 13 (45%) during-pandemic enrolees. Completely homebased programs were provided to 4 (25%) of the pre-pandemic enrolees and to 13 (100%) of the during-pandemic enrolees (p=0.0002). Almost all pre-pandemic enrolees resided outside Chennai and travelled by air/train/road for in-person sessions in the hybrid program;an elderly woman residing in Chennai preferred the hybrid program, as she needed a caregiver to accompany her. Majority of pre-pandemic home-based sessions were phone calls whereas majority of during-pandemic sessions were online video sessions with supervised exercise and/or audiovisual presentation. FC was assessed using 6MWT in 17 (59%) and 2MST in 9 (31%) subjects;FC was not assessed in 3 pre-pandemic enrolees. No adverse events were reported.

Conclusion:

Multidisciplinary HBCR/HBPP is an effective and safer alternative to traditional programs. There is potential to expand these services post-pandemic to all patients irrespective of place of residence and risk profile.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of the Hong Kong College of Cardiology Year: 2020 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Journal of the Hong Kong College of Cardiology Year: 2020 Document Type: Article