title: A EUropean study on effectiveness and sustainability of current Cardiac Rehabilitation programmes in the Elderly: Design of the EU-CaRE randomised controlled trial.
abstract: Cardiac rehabilitation (CR) is an evidence-based intervention to increase survival and quality of life. Yet studies consistently show that elderly patients are less frequently referred to CR, show less uptake and more often drop out of CR programmes.
  
  
  
  The European study on effectiveness and sustainability of current cardiac rehabilitation programmes in the elderly (EU-CaRE) project consists of an observational study and an open prospective, investigator-initiated multicentre randomised controlled trial (RCT) involving mobile telemonitoring guided CR (mCR).
  
  
  
  The aim of EU-CaRE is to map the efficiency of current CR of the elderly in Europe, and to investigate whether mCR is an effective alternative in terms of efficacy, adherence and sustainability.
  
  
  
  The EU-CaRE study includes patients aged 65 years or older with ischaemic heart disease or who have undergone heart valve surgery. A total of 1760 patients participating in existing CR programmes in eight regions of Europe will be included. Of patients declining regular CR, 238 will be included in the RCT and randomised in two study arms. The experimental group (mCR) will receive a personalised home-based programme while the control group will receive no advice or coaching throughout the study period. Outcomes will be assessed after the end of CR and at 12 months follow-up. The primary outcome is VO2peakand secondary outcomes include variables describing CR uptake, adherence, efficacy and sustainability.
  
  
  
  The study will provide important information to improve CR in the elderly. The EU-CaRE RCT is the first European multicentre study of mCR as an alternative for elderly patients not attending usual CR.
authors.affiliation: Department of Cardiology, University of Copenhagen, Denmark.
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.affiliation: Isala Heart Centre, The Netherlands.|Department of Cardiology, Radboud University, The Netherlands.
authors.forename: Esther P
authors.initials: EP
authors.lastname: Meindersma
authors.affiliation: Isala Heart Centre, The Netherlands a.vdvelde@isala.nl.
authors.forename: Astrid E
authors.initials: AE
authors.lastname: van der Velde
authors.affiliation: Department of Cardiology, University Hospital, Santiago de Compostella, Spain.
authors.forename: Jose R
authors.initials: JR
authors.lastname: Gonzalez-Juanatey
authors.affiliation: Department of Cardiac Rehabilitation, Assistance Publique Hopitaux de Paris, France.
authors.forename: Marie Christine
authors.initials: MC
authors.lastname: Iliou
authors.affiliation: Department of Cardiology, Parma University Hospital, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Ardissino
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, and Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy.
authors.forename: Giuseppe Biondi
authors.initials: GB
authors.lastname: Zoccai
authors.affiliation: Klinikum Ludwigshafen and Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Zeymer
authors.affiliation: Diagram B.V., The Netherlands.
authors.forename: Leonie F
authors.initials: LF
authors.lastname: Prins
authors.affiliation: Isala Heart Centre, The Netherlands.
authors.forename: Arnoud Wj
authors.initials: AW
authors.lastname: Van't Hof
authors.affiliation: Department of Cardiology, Universität Bern, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Wilhelm
authors.affiliation: Isala Heart Centre, The Netherlands.
authors.forename: Ed P
authors.initials: EP
authors.lastname: de Kluiver
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D000367:Age Factors; D000072038:Cardiac Rehabilitation / Q000191:economics / Q000379:methods; D003362:Cost-Benefit Analysis; D005060:Europe; D017079:Exercise Tolerance; D017048:Health Care Costs; D006331:Heart Diseases / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000534:rehabilitation; D010101:Oxygen Consumption; D010349:Patient Compliance; D011446:Prospective Studies; D020127:Recovery of Function; D012107:Research Design; D017216:Telemedicine / Q000191:economics; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac rehabilitation; Europe; coronary heart disease; effectiveness; elderly; mHealth; telemonitoring