The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

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Authors

BAŤALÍK Ladislav FILAKOVA Katerina SLÁDEČKOVÁ Michaela DOSBABA Filip SU Jingjing PEPERA Garyfallia

Year of publication 2023
Type Article in Periodical
Magazine / Source EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.minervamedica.it/en/journals/europa-medicophysica/article.php?cod=R33Y2023N02A0248
Doi http://dx.doi.org/10.23736/S1973-9087.23.07773-0
Keywords Telemedicine; Cardiac rehabilitation; Costs and cost analysis; Exercise
Description INTRODUCTION: Alternatives such as remotely delivered therapy in the home environment or telehealth represent an opportunity to increase overall cardiac rehabilitation (CR) utilization. Implementing alternatives into regular practice is the next step in development; however, the cost aspect is essential for policymakers. Limited economic budgets lead to cost-effectiveness analyses before implementation. They are appropriate in cases where there is evidence that the compared intervention provides a similar health benefit to usual care. This systematic review aimed to compare the cost-effectiveness of exercise-based telehealth CR interventions compared to standard exercise-based CR.EVIDENCE ACQUISITION: PubMed and Web of Science databases were systematically searched up to August 2022 to identify randomized controlled trials assessing patients undergoing telehealth CR. The intervention was compared to standard CR protocols. The primary intent was to identify the cost-effectiveness. Interventions that met the criteria were home-based telehealth CR interventions delivered by information and communications technology (telephone, computer, internet, or videoconferencing) and included the results of an economic evaluation, compar-ing interventions in terms of cost-effectiveness, utility, costs and benefits, or cost-minimization analysis. The systematic review protocol was registered in the PROSPERO Registry (CRD42022322531).EVIDENCE SYNTHESIS: Out of 1525 identified studies, 67 articles were assessed for eligibility, and, at the end of the screening process, 12 studies were included in the present systematic review. Most studies (92%) included in this systematic review found strong evidence that exer-cise-based telehealth CR is cost-effective. Compared to CBCR, there were no major differences, except for three studies evaluating a significant difference in average cost per patient and intervention costs in favor of telehealth CR.CONCLUSIONS: Telehealth CR based on exercise is as cost-effective as CBCR interventions. Funding telehealth CR by third-party payers may promote patient participation to increase overall CR utilization. High-quality research is needed to identify the most cost-effective design.

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