Alternative Models of Cardiac Rehabilitation to Promote Secondary Prevention in Patients With Coronary Heart Disease After Percutaneous Coronary Intervention: A Scoping Review.

Abstract

Background: Although cardiac rehabilitation (CR) is an effective secondary prevention strategy, it remains underutilized worldwide. Barriers to accessibility and adherence to traditional hospital-based programs have led to the development of alternative models, such as home-based CR, to improve healthcare delivery and patient outcomes.

Objective: In this study, we aimed to map and synthesize evidence of effective home-based CR models for promoting secondary prevention in patients with coronary heart disease after percutaneous coronary intervention.

Methods: Following the Joanna Briggs Institute methodology, we conducted a scoping review across 7 databases: Cochrane, CINAHL, Scopus, MEDLINE, Embase, PubMed, and Web of Science, and gray literature sources. The search included primary English-language articles published in the last decade, with an update extending to October 2024. Reviewers independently assessed eligibility, and data extraction followed the Template for Intervention Description and Replication and PRISMA guidelines.

Results: Among the 3296 initially identified articles, 23 met the inclusion criteria. The identified home-based CR models varied in duration (6 weeks to 6 months) and used a range of technological tools, such as Internet platforms and telecommunication, for exercise supervision and patient communication. These programs include supplementary equipment and educational resources to enhance patient self-efficacy and cardiovascular disease awareness.

Conclusions: All identified home-based CR models showed positive patient outcomes, with high program enrollment and adherence to secondary prevention measures. Further research is needed to compare different home-based CR models and assess their feasibility in diverse settings.