{ "release_id": "5dcd9b263fe17744", "id": "cardio:idea-home-based-cardiac-rehab", "owner": "cardio", "kind": "idea", "slug": "idea-home-based-cardiac-rehab", "name": "Home-based cardiac rehabilitation", "aliases": [ "HBCR" ], "atlases": [ "cardio" ], "summary_plain": "The idea is to offer cardiac rehabilitation at home, with remote coaching and indirect supervision of exercise, instead of only in a supervised center. A joint scientific statement from rehabilitation and cardiology societies says home-based programs have been used in the United Kingdom, Canada and other countries, while most US healthcare organizations have little to no experience with them. Earlier randomized trials gave low- to moderate-strength evidence that home-based and center-based programs can achieve similar clinical outcomes over 3 to 12 months. The statement says home-based rehabilitation may be a reasonable option for selected clinically stable low- to moderate-risk patients who are eligible but cannot attend a center-based program, and it asks for more research in older adults, women and other understudied groups.", "summary_technical": "Hypothesis page, maturity set to tested because the statement reviews earlier randomized trials, but the statement rates their evidence low to moderate in strength. The source is a PubMed abstract of a joint scientific statement from the cardiovascular and pulmonary rehabilitation association AACVPR, the American Heart Association and the American College of Cardiology (Circulation, 2019), recorded in the claim on this page; the full statement was not read, and no home-based trial is recorded separately here.", "editorial_state": "draft", "last_substantive_edit": "2026-10-15", "last_evidence_check": "2026-10-15", "next_review_due": null, "identifiers": [], "navigation": { "cardio": { "system": [ "heart" ], "condition-area": [ "acute-care-and-long-term-living" ] } }, "payload": { "hypothesis": "Home-based cardiac rehabilitation, which relies on remote coaching with indirect exercise supervision, can achieve clinical outcomes similar to center-based rehabilitation and so reach eligible people who do not attend center-based programs.", "rationale": "The statement says cardiac rehabilitation programs are significantly underused in the United States, with only a minority of eligible patients taking part, and that new delivery strategies are urgently needed to improve participation.", "test": "The statement identifies the core components, efficacy, strengths, limitations, evidence gaps and research needed to guide delivery of home-based rehabilitation in the United States, and draws on earlier randomized trials of 3- to 12-month outcomes.", "maturity": "tested", "proponents": [], "objections": [ "The evidence from earlier randomized trials is of low to moderate strength.", "Additional research and demonstration projects are needed for key subgroups, including older adults, women, underrepresented minority groups and other higher-risk and understudied groups.", "Most US healthcare organizations have little to no experience with home-based programs.", "The statement supports it only as an option for selected clinically stable low- to moderate-risk patients who are eligible but cannot attend a traditional center-based program." ] }, "content_digest": "b10bb0297fd86ab667cec9aa991cadf6b1da14c16694af4e2c0021ea43db9c36", "review": { "content_digest": "b10bb0297fd86ab667cec9aa991cadf6b1da14c16694af4e2c0021ea43db9c36", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "5dcd9b263fe17744", "id": "cardio:claim-hbcr-scientific-statement", "owner": "cardio", "subject_entity_id": "cardio:idea-home-based-cardiac-rehab", "category": "descriptive", "statement": "A scientific statement from the cardiovascular and pulmonary rehabilitation association AACVPR, the American Heart Association and the American College of Cardiology says previous randomized trials have generated low- to moderate-strength evidence that home-based and center-based cardiac rehabilitation can achieve similar improvements in 3- to 12-month clinical outcomes. It concludes that home-based cardiac rehabilitation may be a reasonable option for selected clinically stable low- to moderate-risk patients who are eligible for cardiac rehabilitation but cannot attend a traditional center-based program. It says additional research is needed to clarify, strengthen and extend the evidence for key subgroups, including older adults, women, underrepresented minority groups and other higher-risk and understudied groups.", "context": { "id": "cardio:ctx-hbcr-selected-stable-patients", "label": "Selected clinically stable low- to moderate-risk patients eligible for cardiac rehabilitation who cannot attend a center-based program", "recipient": "adult", "population": "Selected clinically stable low- to moderate-risk patients who are eligible for cardiac rehabilitation but cannot attend a traditional center-based program (the statement's conclusion). The statement says the evidence for older adults, women, underrepresented minority groups and other higher-risk and understudied groups needs more research.", "care_setting": "Home-based programs that rely on remote coaching with indirect exercise supervision, provided mostly or entirely outside the traditional center-based setting.", "geography": "United States focus: the statement aims to guide delivery in the United States, and notes use in the United Kingdom, Canada and other countries.", "life_stage_note": "Adults", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Earlier randomized trials reported 3- to 12-month clinical outcomes.", "eligibility": { "inclusion": [ "Eligible for cardiac rehabilitation but unable to attend a traditional center-based program", "Clinically stable", "Low to moderate risk" ], "exclusion": [] } }, "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "The statement rates the supporting evidence as low to moderate in strength and supports home-based rehabilitation only as an option for selected patients. Only the PubMed abstract was read. This is expert guidance, not a trial result.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, paragraph 1, sentences 8 to 10", "applicability_note": "Evidence strength, conclusion and research needs.", "snapshot": { "id": "cardio:pubmed-31082266-2026-10-15", "retrieved_at": "2026-10-15T13:48:14Z", "content_hash": "826982c6fe78c5bd8a7b612fbd6af9232ad966689235ccf3f9d64e3e36ccc15b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1161-cir-0000000000000663", "source_type": "publication", "title": "Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology", "canonical_url": "https://doi.org/10.1161/CIR.0000000000000663", "identifiers": [ { "scheme": "doi", "value": "10.1161/CIR.0000000000000663", "normalized_value": "10.1161/cir.0000000000000663", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "31082266", "normalized_value": "31082266", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2019-07-02", "publisher": "Circulation", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Abstract, paragraph 1, sentences 4 to 6", "applicability_note": "What home-based programs are and where they are used.", "snapshot": { "id": "cardio:pubmed-31082266-2026-10-15", "retrieved_at": "2026-10-15T13:48:14Z", "content_hash": "826982c6fe78c5bd8a7b612fbd6af9232ad966689235ccf3f9d64e3e36ccc15b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1161-cir-0000000000000663", "source_type": "publication", "title": "Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology", "canonical_url": "https://doi.org/10.1161/CIR.0000000000000663", "identifiers": [ { "scheme": "doi", "value": "10.1161/CIR.0000000000000663", "normalized_value": "10.1161/cir.0000000000000663", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "31082266", "normalized_value": "31082266", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2019-07-02", "publisher": "Circulation", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). 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