Effects of community based cardiac rehabilitation: Comparison with a hospital-based programme

Background: With typically fewer than 35% of eligible patients attending outpatient cardiac rehabilitation (CR), more accessible provision is required. Community-based cardiac rehabilitation is one option but its effects need to be
compared with those of hospital-based CR.
Aims: The purpose of this study was to compare changes in health-related quality of life (HRQOL), anxiety and depression, and exercise and smoking rates, between attendees at community-based and hospital-based CR programmes.
Method: A prospective comparative cohort design was used. Consecutive patients admitted to Aberdeen Royal Infirmary and eligible for CR were recruited and followed up by self-report questionnaire. Outcomes were health status
(RAND-36), Hospital Anxiety and Depression Scale (HADS), Godin Leisure-Time Exercise and smoking status.
Results: There were 136 of 179 (75%) attenders at community-based CR, compared to 169 of 209 (80%) at hospital based CR (p=0.242). In univariate analysis, there were no significant differences between the two groups in health status, HADS, and frequency or intensity of exercise immediately after the CR programme or six months later. Adjusting for other significant factors, patients who attended community CR reported higher RAND-36 energy scores at six months compared with attenders at hospital CR (p=0.020), but were less likely to undertake frequent exercise (p=0.041).
Conclusions: Community-based CR appears to achieve similar attendance rates and effects on health status and health behaviour as hospital-based CR. This option might help overcome the poor attendance of patients with long travelling times to hospital-based CR.