Cost-Effectiveness of Exercise Facilitation Post-Cardiac Rehabilitation

Background: Physical activity declines post-cardiac rehabilitation (CR) suggests the need for an exercise maintenance intervention. The study objectives were to assess (1) health-care resource utilization, (2) QALYs, and (3) intervention cost-effectiveness.

Methods: A randomized controlled trial of post-CR participants allocated to: (a) exercise facilitator intervention, or (b) usual care. Participants were randomized and asked to complete a baseline and follow-up surveys.

Results: Overall, 297 (16.7%) graduates consented (50.2% intervention), of which 276 (92.9%) were retained at the 26 week and 264 (88.9%) were retained at 52 weeks. At 26 weeks, there were significant differences in emergency department mean visits (0.33±0.71 [control], 0.22±0.51 [intervention]) and hospitalizations (0.16±0.39[control], 0.07±0.28[intervention]). At 52 weeks, interventional participants had higher hospitalizations (p<0.05). There were minimal differences in quality of life (QoL) means score and QALYs throughout the trial among groups.

Conclusion: These results suggest that there was an early cost-benefit associated with the intervention from a societal perspective, but this was not sustained at 52 weeks.