Conclusions : Telehealth interventions with a range of delivery modes could be offered to patients who can not attend cardiac rehabilitation , or as an adjunct to cardiac rehabilitation for effective secondary prevention
Background : Coronary heart disease ( CHD ) is a major cause of death worldwide .
Cardiac rehabilitation , an evidence -based CHD secondary prevention programme , remains underutilized .
Telehealth may offer an innovative solution to overcome barriers to cardiac rehabilitation attendance .
We aim ed to determine whether contemporary telehealth interventions can provide effective secondary prevention as an alternative or adjunct care compared with cardiac rehabilitation and /or usual care for patients with CHD .
Four-year follow-up of the Choice of Health Options In prevention of Cardiovascular Events randomized controlled trial
Objective : To determine if the improved risk factor profile at 1 year attributed to the Choice of Health Options In prevention of Cardiovascular Events ( CHOICE ) program was maintained at 4 years . Design : Single-blind r and omized controlled trial with post-hoc 47 ± 6 months follow-up ( 76 % complete ) . Setting : Australian tertiary referral hospital . Patients : Two hundred and eight acute coronary syndrome survivors . Interventions : Acute coronary syndrome survivors not accessing cardiac rehabilitation ( CR )  were r and omized to control ( n = 72 ) or CHOICE ( n = 72 ) comprising the tailored risk factor reduction packaged as a clinic visit and 3 months phone support . A contemporary CR reference group were also recruited ( n = 64 ) . Blinded risk assessment occurred at baseline , 1 and 4 years . Main outcome measures : Total cholesterol , systolic blood pressure , smoking status , physical activity . Results : One year improvements in all the modifiable risk factors achieved in CHOICE were maintained at 4 years . CHOICE and control were well-matched at baseline . At 4 years , there was a trend towards lower total cholesterol in CHOICE compared with controls ( mean 4.0 ± 0.1 vs. 4.2 ± 0.1 mmol/l , P = 0.05 ) , significantly better systolic blood pressure ( mean 132.2 ± 2.1 vs. 136.8 ± 2.0 mmHg , P = 0.01 ) , physical activity scores ( 1200 ± 209 vs. 968 ± 196 metabolic equivalent min/week , P = 0.02 ) and proportion with three or more risk factors above national targets ( 20 vs. 42 % , P = 0.02 ) . Participants in CHOICE were at higher baseline risk than CR but at 4 years they had similar risk factor profiles . Conclusion : Participants in CHOICE maintained favorable changes in coronary risk profile at 4 years compared with control , indicating that CHOICE is an effective long-term intervention among those not accessing facility-based CR
Conclusions : Telehealth interventions with a range of delivery modes could be offered to patients who can not attend cardiac rehabilitation , or as an adjunct to cardiac rehabilitation for effective secondary prevention
Background : Coronary heart disease ( CHD ) is a major cause of death worldwide .
Cardiac rehabilitation , an evidence -based CHD secondary prevention programme , remains underutilized .
Telehealth may offer an innovative solution to overcome barriers to cardiac rehabilitation attendance .
We aim ed to determine whether contemporary telehealth interventions can provide effective secondary prevention as an alternative or adjunct care compared with cardiac rehabilitation and /or usual care for patients with CHD .