Home-Based Cardiac Rehabilitation in Patients with Chronic Heart Failure-A Narrative Review

Home-based cardiac rehabilitation designs have been introduced in clinical practice to identify the weaknesses in CR services and quantify patients’ access and participation. Nonetheless, consistent variations of protocols and its effectiveness in high-risk patients remains sceptical. This narrative review aims to update the current literature on HBCR and highlight its importance in the management of chronic heart failure by addressing: (1) effectiveness of home-based versus centre-based CR; (2) structural components; (3) patient characteristics; (4) health-related factors and outcomes (5) utilisation and costeffectiveness; (6) prognosis; (7) pros and cons. No evident differences existed in mortality, cardiac events, exercise‐ capacity, healthcare costs, modifiable risk factors and HRQoL between home-based and centre-based CR; but HBCR had increased programme completion and adherence. HBCR is composed of patient assessment, exercise training, dietary counselling, risk factor management, and psychosocial intervention. Limited evidence of differential effects exists across patient-related outcomes which indicates Turkish Journal of Physiotherapy and Rehabilitation; 32(3) ISSN 2651-4451 | e-ISSN 2651-446X www.turkjphysiotherrehabil.org 25067 similar improvements, regardless of age, sex, current fitness or disease severity. HBCR programmes are safe, effective and affordable choice for low-to-moderate risk HF patients; yet underutilisation persists. CR provides improved health-related outcomes, reduced cardiovascular events and mortality. Nevertheless, the long-term impact of homebased CR on patients’ quality of life and clinical outcomes needs to be further evaluated.