Telehealth as Alternative to Cardiac Rehabilitation

As the holidays draw near, think about your heart health. If you or you know someone who has had a heart complication and/or underwent cardiac surgery, then you may be familiar with the three traditional phase of cardiac rehabilitation (CR): 1. Early mobilization and education in the hospital, varying between 4-7 days, 2. Outpatient programs, from discharge from the hospital and up to 3 months, and 3. Maintenance programs.

Although there is ample research documenting the multiple health benefits of traditional CR, limited participation is a concern. Some of the reasons why this is include lack of transportation, conflicting work schedules, social commitments, lack of perceived need, and functional impairments. 

According to a systematic review by Clark, Conway, Poulsen, Keech, Trimacco, and Tideman (2013) of the literature and research out there about alternative models of CR, 17 studies were found that included programs in the "multifactorial individualized telehealth delivery" category. The review showed that this type of alternative CR provides similar results to the traditional hospital->outpatient-> maintenance programs in terms of lowering cardiovascular disease risk. 

What does that mean, what do these programs consist of? Can I benefit?

Multifactorial Individualized Telehealth

This type of CR is provided via telephone, addresses multiple risk factor areas, and is individualized to each patient. These programs focus on providing individualized information and treatments via telephone, instead of in person at a clinic. Multiple risk factors are addressed and each person is individually assessed for risk and given individual treatments to lower that risk and improve their health to prevent another cardiac event. Other features of these types of interventions include the active participation of each patient in determining which health goals they want to focus on, how they want to achieve each goal, and the re-evaluation and modification of goals. Communication with a local doctor and treating cardiologist is also included in most programs. 

This type of health delivery model seems to produce better results than mobile apps that provide feedback regarding blood pressure, heart rate, exercise routines, etc. possibly due to the human contact through the telephone. 

The  review also points out that brief phone interactions were just as effective if not more effective than more extended telehealth programs. This may be due to the smaller/shorter time and energy commitment. So even a small phone interventions can have big health benefits and help to lower a patient's cardiovascular disease risk. 

Why Would I Opt for Telehealth?

It's convenient and works around your schedule, whether you are busy with your family and/or have a job to juggle. The lack of transportation is no longer a problem since treatments are provided over the phone or internet. It can be as short or long of a treatment as you want it to be as well, since it is individualized to your needs. 

Who Provides This Service? 

If you or your loved one is in a hospital, make sure to ask the case manager for information regarding accessible multifactorial individualized telehealth programs. 

DAMON's Monthly Text/Email/Phone Program

DAMON offers a $200 a month program that includes up to 4 hours of treatment and education via phone, text, or email that can be applied towards cardiac rehabilitation. During each session, each client is assessed and treated individually. Coordination and communication with your primary care physician as well as your cardiologist is emphasized so that we can work together to compile the different health goals that you can choose to participate in. 

 

References: 

Clark, R. A., Conway, A.,Poulsen, V., Keech, W., Tirimacco, R., & Tiderman, P. (2013). Alternative models of cardiac rehabilitation, A systematic review. European Journal of Preventive Cardiology, 22(1), 35-74.

Resources: 

American Heart Association