Asynchronous and Synchronous Delivery Models for Home-Based Cardiac Rehabilitation: A SCIENTIFIC REVIEW.
Asynchronous and Synchronous Delivery Models for Home-Based Cardiac Rehabilitation: A SCIENTIFIC REVIEW.
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DOI：
10.1097/hcr.0000000000000656
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发表时间：
2021-11-01
影响因子：
3.8
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中科院分区：
文献类型：
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回顾家庭心脏康复（HBCR）的异步和同步交付模式的原理、优点和缺点。我们回顾了最近发表的异步和同步 HBCR 随机研究的系统综述和其他出版物，以评估这些交付方法与中心心脏康复 (CBCR) 相比的原理、结果和局限性。虽然 2016 年之前的大多数研究涉及异步 HBCR 护理方法，但 2016 年以来的研究已包括异步或同步交付模型。两种交付模式均已被证明有助于提供心脏康复 (CR) 的核心组成部分。使用这两种方法的研究已显示出与 CBCR 相似的短期患者结果，至少在所研究的低至中风险患者中是如此。异步 HBCR 为患者和 CR 工作人员提供了更大的灵活性，而同步 HBCR 为患者提供了更大的实时监督和反馈。异步和同步 HBCR 是符合 CR 资格的患者可以考虑的一种选择。需要对两种交付模式单独或组合应用进行更多研究，以比较它们对短期和长期患者结果的影响，并评估它们对患者亚组（转诊诊断、女性、老年人、代表性不足的种族和族裔群体、心血管疾病风险较高的患者、患有多种合并症的患者等）的影响。
To review the principles, advantages, and disadvantages of asynchronous and synchronous delivery models of home-based cardiac rehabilitation (HBCR). We reviewed recently published systematic reviews and other publications of randomized studies of asynchronous and synchronous HBCR to assess principles, outcomes, and limitations of those delivery methods compared with center-based cardiac rehabilitation (CBCR). While most studies prior to 2016 involved asynchronous HBCR approaches to care, studies since 2016 have included asynchronous or synchronous delivery models. Both delivery models have been shown to help provide core components of cardiac rehabilitation (CR). Studies using either method have been shown to have similar short-term patient outcomes as CBCR, at least in low- to moderate-risk patients who have been studied. Asynchronous HBCR offers greater flexibility for patients and CR staff, while synchronous HBCR provides greater real-time oversight and feedback to patients. Asynchronous and synchronous HBCR is an option to consider for patients eligible for CR. Additional research is needed for both delivery models, applied separately or in combination, to compare their impact on shorter- and longer-term patient outcomes and to assess their impact in patient subgroups (referral diagnosis, women, elderly, underrepresented racial and ethnic minority groups, patients at a higher cardiovascular disease risk, patients with multiple comorbid conditions, etc).