Participating in home-based Cardiac rehabilitation — following a heart attack or cardiac procedure — can help lower the possibility of death resulting from heart-related complications.

Specifically, home-based cardiac rehabilitation led to a 36% decrease in death within four years of participation. That’s according to new research published Wednesday in the Journal of the American Heart Association.

A little under half of the study’s participants were enrolled in home-based cardiac rehabilitation, which was centered around heart-healthy behaviors.

Though the study focused solely on U.S. military veterans, those veterans were seniors.

“The findings apply generally to at least men’s male seniors,” Dr. Mary A. Whooley, a primary care physician at the San Francisco Veterans Affairs (VA) Medical Center and professor of medicine at the University of California, San Francisco, told Home Health Care News. “It’s also the case in the U.K., they’ve done studies for years now that have shown that home-based cardiac rehab is associated with lower mortality in all kinds of patients.”

Whooley emphasized that there are two main reasons why the home-based component of this rehabilitation is crucial to the results.

“The first is that it’s much more accessible,” she said. “Patients don’t have to drive into a hospital or facility to attend in-person sessions three times a week. That’s just not feasible for the majority of veterans, many of whom live in rural locations.”

The other main reason was that learning about cardiac rehab in the home setting may have cause for a better integration into the person’s regular routine compared to facility-based care.

“Some patients who participate in traditional cardiac rehab think once they’re done with their 12 weeks of sessions, ‘Okay, I’m done,’” Whooley said. “‘Time to go back to my old ways of doing things.’”

Whooley noted that the entire point of cardiac rehab is making lifestyle and health behavior changes. This means working out a home routine that includes more physical activity, healthy eating, keeping up a medication schedule as directed, managing stress, and making all of this part of daily life rather than as a separate treatment.

These findings also present an opportunity for home-based care providers.

“The main aspects of cardiac rehab are five different behavior changes,” Whooley said. “The first is physical activity. The second is healthy eating. The third is taking the medications that one is supposed to be taking, as prescribed. The fourth is to stop smoking, if that’s an issue, and the fifth is stress management. Those are five health behaviors that any home health provider can teach patients.”

Indeed, physical activity is especially important because many patients are afraid to start exercising again after a cardiac event due to fear that it could have a negative effect on their heart, according to Whooley.

“Not only is it safe to be active, it’s going to save your life,” she said. “It’s going to help you live longer, so let’s get some kind of routine going where physical activity can be part of every single day. Home health agencies can definitely do all of those things.”

Less than roughly 20% of patients participate in cardiac rehab. The ability to bring the therapy to the patient’s home, and knowing it will likely have a positive outcome, is important and could impact future Medicare policy.

“Currently, Medicare only pays for cardiac rehab that is done in a traditional facility setting,” Whooley said. “They do not pay for cardiac rehab that is done in a home setting. This evidence may help Medicare eventually decide that it is worth covering the costs of home-based cardiac rehab, because in the long run, it may actually save health care costs by reducing the number of cardiac events that happen.”

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