title: Home-based versus centre-based cardiac rehabilitation: abridged Cochrane systematic review and meta-analysis.
abstract: To update the Cochrane review comparing the effects of home-based and supervised centre-based cardiac rehabilitation (CR) on mortality and morbidity, quality of life, and modifiable cardiac risk factors in patients with heart disease.
  
  
  
  Systematic review and meta-analysis. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO and CINAHL were searched up to October 2014, without language restriction. Randomised trials comparing home-based and centre-based CR programmes in adults with myocardial infarction, angina, heart failure or who had undergone coronary revascularisation were included.
  
  
  
  17 studies with 2172 patients were included. No difference was seen between home-based and centre-based CR in terms of: mortality (relative risk (RR) 0.79, 95% CI 0.43 to 1.47); cardiac events; exercise capacity (mean difference (MD) -0.10, -0.29 to 0.08); total cholesterol (MD 0.07 mmol/L, -0.24 to 0.11); low-density lipoprotein cholesterol (MD -0.06 mmol/L, -0.27 to 0.15); triglycerides (MD -0.16 mmol/L, -0.38 to 0.07); systolic blood pressure (MD 0.2 mm Hg, -3.4 to 3.8); smoking (RR 0.98, 0.79 to 1.21); health-related quality of life and healthcare costs. Lower high-density lipoprotein cholesterol (MD -0.07 mmol/L, -0.11 to -0.03, p=0.001) and lower diastolic blood pressure (MD -1.9 mm Hg, -0.8 to -3.0, p=0.009) were observed in centre-based participants. Home-based CR was associated with slightly higher adherence (RR 1.04, 95% CI 1.01 to 1.07).
  
  
  
  Home-based and centre-based CR provide similar benefits in terms of clinical and health-related quality of life outcomes at equivalent cost for those with heart failure and following myocardial infarction and revascularisation.
authors.affiliation: Department of Research, Development & Innovation , Royal Cornwall, Hospitals NHS Trust , Truro , UK.
authors.forename: S A
authors.initials: SA
authors.lastname: Buckingham
authors.affiliation: Institute of Health Research (Primary Care), University of Exeter Medical School , Exeter, Devon , UK.
authors.forename: R S
authors.initials: RS
authors.lastname: Taylor
authors.affiliation: Institute for Applied Health Research, University of Birmingham , Birmingham , UK.
authors.forename: K
authors.initials: K
authors.lastname: Jolly
authors.affiliation: Agency for Health Technology Assessment and Tariff System , Warsaw , Poland.
authors.forename: A
authors.initials: A
authors.lastname: Zawada
authors.affiliation: Institute of Health Research (Primary Care), University of Exeter Medical School , Exeter, Devon , UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Dean
authors.affiliation: Cardiac Rehabilitation , University Hospital Ayr , Ayr , UK.
authors.forename: A
authors.initials: A
authors.lastname: Cowie
authors.affiliation: Institute of Bioengineering, School of Engineering and Materials Science, Queen Mary University of London , London , UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Norton
authors.affiliation: Department of Research, Development & Innovation, Royal Cornwall, Hospitals NHS Trust, Truro, UK; Institute of Health Research (Primary Care), University of Exeter Medical School, Exeter, Devon, UK.
authors.forename: H M
authors.initials: HM
authors.lastname: Dalal
keywords: CORONARY ARTERY DISEASE; HEART FAILURE