SPC365

Adherence and cost-related outcomes of a hybrid telemonitored cardiac rehabilitation after acute myocardial infarction: a systematic review

Session: Sessão de Posters 36 - Reabilitação para todos: equidade, inovação e impacto a longo prazo
Speaker: Pinheiro Candjondjo

Congress: CPC 2026
Topic: J. Preventive Cardiology
Theme: 29. Rehabilitation and Sports Cardiology
Subtheme: 29.2 Cardiovascular Rehabilitation
Session Type: Posters Eletrónicos
FP Number: ---
Authors: Pinheiro Candjondjo; José Moreira; Miguel Mendes; Artur Lopes; Jorge Mimoso; Teresa Magalhães
<p style="text-align:justify"><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">BACKGROUND:</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black"> Hybrid telemonitored cardiac rehabilitation (HTCR), which integrates in-hospital care with telehealth technologies, has emerged as a flexible and accessible alternative to address the challenges and barriers of participation and adherence. </span></span></span><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">AIM:</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black"> To evaluate the adherence and c</span></span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Aptos&quot;,sans-serif">ost-related outcomes </span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">of HTCR programs for patients after acute myocardial infarction (AMI) compared to Centre-based cardiac rehabilitation (CBCR).<strong>&nbsp;</strong></span></span></span><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">METHODS:</span></span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black"> The systematic review and meta-analysis were registered in the International Prospective Register of Systematic Review (PROSPERO) with registration number CRD420251243824. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-2020) guidelines, analyzing studies published in the last decade. The databases utilized for this review included PubMed, SCOPUS, EMBASE, Cochrane Library, Virtual Health Library and Web of Science. Inclusion criteria encompassed peer-reviewed randomized controlled trials (RCTs), focusing on HTCR programs for adults after AMI and reporting outcomes related to adherence and c</span></span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Aptos&quot;,sans-serif">ost-related outcomes</span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">. </span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">The quality of the included RCTs was assessed using the Cochrane ROB_2 (Risk of Bias 2.0) tool</span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Aptos&quot;,sans-serif">. </span></span><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">RESULTS:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> After screening 350 articles, 5 studies RCTs fulfilled the defined inclusion criteria and were considered in the review and only two economic evaluations met the review inclusion criteria. This review included a total of 526 participants, of which 425 were male (80.6%). The weighted mean age of the participants was 59.0 years.&nbsp;According to the risk of bias, 60% of the studies present a low risk and only 25% present a high risk.&nbsp;</span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Findings consistently highlighted the high patient adherence to the HTCR rates compared to CBCR </span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">attributed to the flexibility and accessibility of telemonitored components. In terms of cost-related outcomes, the t</span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">wo studies have demonstrated cost reductions associated with the impact of the </span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">HTCR program</span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">. </span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">Together, these studies indicate that HTCR may reduce overall economic burden through decreased healthcare utilisation, lower patient-level indirect costs and favourable cost-effectiveness profiles, despite heterogeneity in how cost-related outcomes were defined across studies. </span></span><strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">CONCLUSION:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"> <span style="color:black">HTCR represents a transformative approach to cardiac rehabilitation, offering a scalable, patient-center model that improves participation, adherence and clinical outcomes, while reducing healthcare costs and, are thus, as cost-effective as CBCR, d</span></span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">espite the available evidence on hybrid models of cardiac rehabilitation after AMI remains limited, especially with regard to economic evaluation.&nbsp;</span></span></span></p>

<p style="text-align:justify"><span style="font-size:12pt"><span style="font-family:&quot;Aptos&quot;,sans-serif"><span style="font-size:10.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">Keywords: Hybrid Telemonitored Cardiac Rehabilitation, Acute Myocardial Infarction, Feasibility, Adherence, cost-related outcomes.</span></span></span></span></span><strong><span style="font-size:13.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><span style="color:black">&nbsp;</span></span></span></strong></p>