Byline: Hassan. Okati-Aliabad, Alireza. Ansari- Moghaddam, Hamidreza. Roohafza, Mahdi. Mohammadi, Leila. Vakili, Mohammad. Abbasi, Hossein. Heidari, Gholamreza. Masoudy, Safoura. Yazdekhasti, Masoumeh. Sadeghi
Background: Cardiovascular diseases are the leading causes of mortality all around the world. Patients with Ischemic heart disease (IHD) are at an increased risk of ischemic events; therefore, secondary prevention measures should continue for these patients. Although Cardiac rehabilitation (CR) is one of the secondary prevention measures for IHD patients which has favorable clinical outcomes, only 50% of patients are referred and among them, a small percentage attends CR. Therefore, other strategies should be considered, one of which is home-based cardiac rehabilitation. Methods: A multicenter, parallel-group randomized controlled trial has been conducting in three hospitals in Isfahan and patients have been assigned into a 1:1 ratio for the evaluation of the effectiveness of home-based cardiac rehabilitation versus usual care. Psycho-educational consultation based on the Health Action Process Approach including heart-healthy diet, stress management, lifestyle changes, smoking cessation, and physical activity has been performed. Primary outcomes, including the quality of life, psychological and smoking status, body mass index, blood pressure, blood cholesterol level, and physical activity level have been measured at 6 months after the randomization and intervention. One year after the intervention, primary and secondary outcomes, including cardiovascular events, the frequency of hospital admissions, and the death rates due to cardiovascular reasons will be assessed. Conclusion: HBCR program can increase patient accessibility to CR services its implantation can be reduce burden IHD.
Introduction
Cardiovascular diseases are the leading cause of mortality globally; it accounts for one-third of all deaths--about 422 million deaths in 2015. While the rate of ischemic heart disease (IHD) in developing countries is increasing due to population aging, cardiovascular risk factors and the more survival rate of patients after cardiovascular events, the secondary prevention measures have reduced the death rate from IHD.[1],[2],[3] After an acute coronary syndrome, especially in the 1-2 years, patients are at an increased risk of ischemic events such as myocardial infarction, stroke, and death. Therefore, secondary prevention measures should be continued for high-risk patients.[4],[5] Cardiac Rehabilitation (CR) is one of the secondary prevention measures which has favorable clinical outcomes such as reduce mortality, decrease hospitalization, increase muscle strength, improve exercise capacity and oxygen consumption as well as health-related quality of life and also being cost-effective for IHD patients.[6],[7],[8] CR is a comprehensive program that encompasses a wide range of measures such as patients risk assessment, nutrition counseling, weight, blood pressure, lipid, diabetes and psychosocial management, and smoking cessation.[9],[10] Despite the proven benefits of CR, patient referral to this valuable program is low and only 50% of patients are referred and among them, a small percentage attends CR. Several factors are influential in attending CR, some of which are related to patient characteristics, and others are related to access to cardiac rehabilitation services.[11],[12],[13],[14] Therefore, other strategies to increase participation in the CR program for More than 80% of eligible patients who do not participate in a center-based rehabilitation program should be considered,...