Centre-based cardiac rehabilitation (CBCR) is typically offered to individuals post cardiac event or diagnosis to support recovery and reduce risk of future cardiovascular events. Despite strong recommendations for referral of individuals with coronary heart disease (CHD) and heart failure (HF) to cardiac rehabilitation (CR) programmes in clinical guidelines, global access remains limited, and participation remains poor.

Home-based CR (HBCR) programmes, including those supported by technology and facilitated by healthcare professionals, are increasingly being used as alternative modes to CBCR in an attempt to widen access to, and uptake of, CR. In 2017, a Cochrane review reported HBCR and CBCR to be equally effective in improving health outcomes.1 Since the SARS-CoV-2 pandemic, there has been an increased use of, and body of evidence emerging for, HBCR. Therefore, we sought to update the previous Cochrane review.

To compare the effect of HBCR (including digital/telehealth technology) and CBCR on mortality and morbidity, health-related quality of life (HRQoL), exercise capacity, modifiable cardiac risk factors, withdrawal, adherence, and costs and health service use, in patients with CHD and HF.

A comprehensive literature search was undertaken on 16 September 2022 to identify studies published since the previous Cochrane Review.1

The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid) and CINAHL (EBSCO) databases, as well as references lists of included studies and clinical trial registers (WHO International Clinical Trials Registry Platform and ClinicalTrials.gov) were searched for eligible published or ongoing randomised controlled trial (RCTs).

Two review authors independently screened titles, abstracts and full texts for RCTs comparing CBCR (undertaken in a variety of settings, mainly secondary or community care) with HBCR programmes (with facilitation from healthcare professionals via telephone calls, letters, home visits or self-monitoring diaries), with or without digital/telehealth technology, in adults (>18 years of age) with myocardial infarction …