Abstract 15475: Comparable Program Delivery Time: Home-Based versus Hospital-Based Cardiac Rehabilitation

Introduction: Home-based cardiac rehabilitation (CR) adds flexibility for patients for whom hospital-based CR may not be accessible. The ERA-NUDGE study is a pragmatic randomized study, conducted at an urban safety-net hospital, which evaluated adherence and clinical outcomes of home- versus hospital-based CR, with mobile phone messaging. The resource requirements associated with home-based CR interactions are not yet well established. We aimed to compare program delivery time between home-based and hospital-based CR programming.

Methods: For one random week in each of 22 months, program delivery times were recorded by a research team member who shadowed hospital CR sessions and reviewed chart notes for home-based CR interactions. Among the sub-set of participants who had interactions during these weeks, we compared time spent on four types of interactions and seven educational topics.

Results: Among 326 patients that completed the parent study, 157 patients had 415 visits during the microcosting weeks (mean of 3.8 visits per patient). Demographics shown in Table 1. Home-based patients accounted for 134 encounters (32%) during microcosting collection weeks. Six- and twelve-week follow-up visits were split between hospital- and home-based groups (53% and 47%, respectively) (Table 2).

Conclusions: Despite documented benefits for patients from CR, access remains low. Home-based CR may present an appealing alternative for patients with difficulties around CR access, but CR program directors may be wary of added staffing requirements to deliver these alternatives. Our analysis suggests that home-based CR can be delivered to patients without increases in personnel time.