Home cardiac rehab reaches underserved groups

Medscape reported on June 2 that home-based digital cardiac rehabilitation programs are reaching women, ethnic minorities and patients from deprived communities who have often been missed by conventional services. The report was published during British Cardiovascular Society conference coverage and pointed to new data and platform examples in the United Kingdom. The broader evidence base already shows why the finding matters: cardiac rehabilitation is effective, but participation has remained low, especially among groups with the biggest access barriers. ### Who is being reached that traditional rehab often misses? Women, ethnic minority patients and people living in deprived areas were identified by Medscape as groups being reached by digital home-based programs. NICE made a similar point when it issued final guidance on December 4, 2025, saying digital platforms could support communities where uptake remains persistently low, “particularly among women, younger people, ethnic minorities, those in deprived areas and those who struggle to attend face-to-face sessions.” (medscape.com) The American Heart Association said in a 2024 scientific statement on women and cardiac rehabilitation that poor participation is especially pronounced in women and that racial and ethnic disparities compound those gaps. A separate Journal of the American Heart Association study on telehealth cardiac rehabilitation said attendance is lowest among women, older adults, Hispanic patients and socially vulnerable groups. (medscape.com) ### Why has standard cardiac rehab left those groups behind? Traditional cardiac rehabilitation is typically delivered in person at a rehab center several times a week over about 12 weeks, which can create barriers around travel, work, caregiving and scheduling. The American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association and the American College of Cardiology said in their home-based rehabilitation statement that only a minority of eligible U.S. patients participate, and that new delivery strategies are urgently needed. (ahajournals.org) NICE said 2023 participation in England was 41% among eligible people with acute coronary syndrome and 13% among those with heart failure. The agency said patients can struggle to attend face-to-face sessions, and that a trained healthcare professional should assess whether digital rehabilitation is appropriate for each patient. ### What do these home programs actually include? (ahajournals.org) NICE said the seven conditionally recommended digital technologies can deliver exercise programs, education on cardiovascular disease and treatment, dietary advice, medication management and psychological support. Some also use wearable devices to monitor activity. The platforms named by NICE were Activate Your Heart, D REACH-HF, Digital Heart Manual, Gro Health HeartBuddy, KiActiv, myHeart and the Pumping Marvellous Cardiac Rehab Platform. (nice.org.uk) The American Heart Association said digital cardiac rehabilitation can be delivered as individual tools or as part of a broader telehealth program, with the aim of improving outcomes and promoting health equity. That advisory said digital tools may help address some of the structural limits of center-based rehabilitation while extending support after enrollment. ### Does home-based rehab work as well as center-based care? (nice.org.uk) The AACVPR, AHA and ACC said randomized trials have generated low- to moderate-strength evidence that home-based and center-based cardiac rehabilitation can produce similar improvements in 3- to 12-month clinical outcomes for selected patients. A recent Lancet Digital Health meta-analysis also evaluated mobile-health home-based interventions against usual care and center-based rehabilitation, reflecting a growing evidence base for remote models. (ahajournals.org) A Journal of the American Heart Association study of 420 adults enrolled in an eight-week home-based program after acute myocardial infarction found hospitalization risk still rose with neighborhood disadvantage. Patients in the most disadvantaged quartile had higher adjusted odds of hospitalization at 30 days and 12 months than those in the least disadvantaged quartile, suggesting access gains alone do not erase structural inequities. (ahajournals.org) ### What happens next? NICE said its seven digital cardiac rehabilitation technologies are being used during a three-year evidence-generation period while more data are collected on long-term effectiveness. The agency said that process will determine whether the technologies should become a permanent part of NHS cardiac care, and Medscape’s June 2 conference report indicates that new subgroup data are already feeding that debate. (nice.org.uk) (ahajournals.org)