Table 1.
Characteristics of Home-Based Programs by World Health Organization Region.
| n (%)/Mean ± Standard Deviation | African (n = 2) | Americas (n = 41) | EMR (n = 5) | Europe (n = 62) | SEAR (n = 2) | Western Pacific (n = 54) | Global (n = 166; 15.3% Total) |
|---|---|---|---|---|---|---|---|
| Year 1st program opened | 2014 | 1979 | 2010 | 1986 | 2005 | 1980 | 1979 |
| % pts served | 20.0 ± 0.0 x̃ = 20.0 Q25–Q75 = 20.0–20.0 |
18.7 ± 18.3 x̃ = 10.0 Q25–Q75 = 5.0–34.8 |
12.5 ± 15.7 x̃ = 7.5 Q25–Q75 = 2.5–25.0 |
12.9 ± 11.8 x̃ = 10.0 Q25–Q75 = 5.0–25.0 |
55.0 ± 35.4 x̃ = 55.0 Q25–Q75 = 30.0–55.0 |
35.6 ± 30.8 x̃ = 22.5 Q25–Q75 = 10.0–60.0 |
21.4 ± 22.8 x̃ = 10.0 Q25–Q75 = 5.0–30.0 |
| % perceive sufficient capacity § | 1 (50.0%) | 19 (46.3%) | 3 (60.0%) | 36 (58.1%) | 1 (50.0%) | 28 (51.9%) | 88 (53.0%) |
| Not enough staff | 0 (0.0%) | 11 (26.9%) | 1 (20.0%) | 15 (24.3%) | 1 (50.0%) | 14 (25.9%) | 42 (25.3%) |
| Not enough funding | 0 (0.0%) | 7 (17.1%) | 2 (40.0%) | 13 (21.0%) | 1 (50.0%) | 8 (14.8%) | 31 (18.7%) |
| Pts too high-risk | 0 (0.0%) | 2 (4.9%) | 1 (20.0%) | 0 (0.0%) | 0 (0.0%) | 3 (5.6%) | 6 (5.2%) |
| Dose | |||||||
| Number sessions pts prescribed per month a | 8.0 ± 0.0 x̃ = 8.0 Q25–Q75 = 8.0–8.0 |
3.2 ± 2.7 x̃ = 3.0 Q25–Q75 = 1.0–4.0 |
6.2 ± 4.6 x̃ = 5.0 Q25–Q75 = 2.0–11.0 |
4.9 ± 7.1 x̃ = 3.0 Q25–Q75 = 2.0–4.0 |
6.5 ± 7.8 x̃ = 6.5 Q25–Q75 = 1.0–6.5 |
3.9 ± 4.2 x̃ = 2.0 Q25–Q75 = 1.0–4.0 |
4.2 ± 5.3 x̃ = 3.0 Q25–Q75 = 1.0–4.0 |
| Program duration (months) | 4.0 ± 0.0 x̃ = 4.0 Q25–Q75 = 4.0–4.0 |
5.8 ± 3.9 x̃ = 4.0 Q25–Q75 = 3.0–6.5 |
2.5 ± 0.8 x̃ = 3.0 Q25–Q75 = 1.6–3.0 |
2.7 ± 2.0 x̃ = 2.0 Q25–Q75 = 2.0–3.0 |
- | 2.3 ± 1.8 x̃ = 1.5 Q25–Q75 = 0.9–3.0 |
3.6 ± 3.1 x̃ = 3.0 Q25–Q75 = 2.0–4.0 |
| Providers Interacting with Pts ‖ | |||||||
| Exercise physiologist or physiotherapist | 2 (100.0%) | 32 (72.0%) | 0 (0.0%) | 44 (72.1%) | 2 (100.0%) | 21 (38.9%) | 101 (60.8%) |
| Nurse | 0 (0.0%) | 12 (29.3%) | 3 (60.0%) | 31 (50.0%) | 0 (0.0%) | 32 (59.3%) | 78 (47.0%) |
| Physician | 0 (0.0%) | 10 (24.4%) | 5 (100.0%) | 14 (22.6%) | 0 (0.0%) | 14 (25.9%) | 43 (25.9%) |
| Basis for Offering | |||||||
| Patient choice | 0 (0.0%) | 36 (87.8%) | 3 (60.0%) | 45 (72.6%) | 2 (100.0%) | 35 (64.8%) | 121 (72.9%) |
| Transportation barriers | 1 (50.0%) | 34 (82.9%) | 5 (100.0%) | 39 (62.9%) | 2 (100.0%) | 29 (53.7%) | 110 (66.3%) |
| Distance | 1 (50.0%) | 35 (85.4%) | 5 (100.0%) | 33 (53.2%) | 2 (100.0%) | 32 (59.3%) | 108 (65.1%) |
| Time or work constraints | 0 (0.0%) | 29 (70.7%) | 2 (40.0%) | 26 (41.9%) | 2 (100.0%) | 25 (46.3%) | 84 (50.6%) |
| Risk stratification | 0 (0.0%) | 24 (58.5%) | 1 (20.0%) | 25 (40.3%) | 1 (50.0%) | 25 (46.3%) | 76 (45.8%) |
| Patient indication | 0 (0.0%) | 20 (48.8%) | 1 (20.0%) | 22 (35.5%) | 1 (50.0%) | 23 (42.6%) | 67 (40.4%) |
| Cost | 1 (50.0%) | 9 (22.0%) | 3 (60.0%) | 6 (9.7%) | 2 (100.0%) | 17 (31.5%) | 38 (22.9%) |
| Exercise Monitoring | |||||||
| Borg perceived exertion [34] | 1 (50.0%) | 20 (48.8%) | 2 (40.0%) | 28 (45.2%) | 2 (100.0%) | 17 (31.5%) | 70 (42.2%) |
| Heart rate | 1 (50.0%) | 22 (53.7%) | 1 (20.0%) | 26 (41.9%) | 1 (50.0%) | 14 (25.9%) | 65 (39.2%) |
| Telemetry | 0 (0.0%) | 0 (0.0%) | 1 (20.0%) | 6 (9.7%) | 0 (0.0%) | 9 (16.7%) | 16 (9.6%) |
| Materials Provided | |||||||
| Education materials (workbook, DVD, website) | 1 (50.0%) | 34 (82.9%) | 3 (60.0%) | 38 (61.3%) | 1 (50.0%) | 37 (68.5%) | 114 (68.7%) |
| Activity tracker (accelerometer, pedometer) | 0 (0.0%) | 24 (58.5%) | 1 (20.0%) | 20 (32.3%) | 1 (50.0%) | 12 (22.2%) | 58 (34.9%) |
| Resistance training materials (e.g., therabands) | 1 (50.0%) | 11 (26.8%) | 1 (20.0%) | 6 (9.7%) | 1 (50.0%) | 7 (13.0%) | 27 (16.3%) |
| Level of Risk Accepted | |||||||
| High | 0 (0.0%) | 12 (29.3%) | 1 (20.0%) | 18 (29.0%) | 1 (50.0%) | 8 (14.8%) | 40 (24.1%) |
| Moderate | 1 (50.0%) | 27 (65.9%) | 4 (80.0%) | 42 (67.7%) | 2 (100.0%) | 23 (42.6%) | 99 (59.6%) |
| Low | 1 (50.0%) | 36 (87.8%) | 4 (80.0%) | 48 (77.4%) | 2 (100.0%) | 30 (55.6%) | 121 (72.9%) |
| Do not risk stratify | 1 (50.0%) | 2 (4.9%) | 0 (0.0%) | 1 (1.6%) | 0 (0.0%) | 10 (18.5%) | 13 (7.8%) |
| Barriers to Communication with pts (% yes) | |||||||
| Lack of pt access (e.g., no computer) | - | 13 (31.7%) | 5 (100.0%) | 12 (19.4%) | 1 (50.0%) | 13 (24.1%) | 44 (26.5%) |
| Logistical problems (e.g., internet connection) | - | 16 (39.0%) | 3 (60.0%) | 7 (11.3%) | 1 (50.0%) | 11 (20.4%) | 38 (22.9%) |
| Difficulty for staff | - | 4 (9.8%) | 2 (40.0%) | 5 (8.7%) | 0 (0.0%) | 8 (14.8%) | 19 (11.4%) |
a formal contact with cardiac rehabilitation staff. § Respondents responding ‘yes’ perceived their program to have sufficient capacity to meet need/demand in the home-base model reported in this row; respondents responding ‘no’ were asked to specify why they do not have sufficient capacity. These are shown in the subsequent three rows (italics). ‖ Total number of providers on staff reported elsewhere [30]; x̃ = median; - no response; Abbreviations: pts = patients; Acronyms: SEAR = South-East Asia region; EMR = Eastern Mediterranean region.