{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T13:06:33Z","timestamp":1794661593521,"version":"4.9.1"},"reference-count":30,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100001511","name":"Auckland Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001511","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2018,6,25]]},"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Compare the effects and costs of remotely monitored exercise-based cardiac telerehabilitation (REMOTE-CR) with centre-based programmes (CBexCR) in adults with coronary heart disease (CHD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants were randomised to receive 12\u2009weeks of telerehabilitation or centre-based rehabilitation. REMOTE-CR provided individualised exercise prescription, real-time exercise monitoring\/coaching and theory-based behavioural strategies via a bespoke telerehabilitation platform; CBexCR provided individualised exercise prescription and coaching via established rehabilitation clinics. Outcomes assessed at baseline, 12 and\/or 24\u2009weeks included maximal oxygen uptake (V\u0307O<jats:sub>2<\/jats:sub>max, primary) modifiable cardiovascular risk factors, exercise adherence, motivation, health-related quality of life and programme delivery, hospital service utilisation and medication costs. The primary hypothesis was a non-inferior between-group difference in V\u0307O<jats:sub>2<\/jats:sub>max at 12\u2009weeks (inferiority margin=\u22121.25\u2009mL\/kg\/min); inferiority margins were not set for secondary outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>162 participants (mean 61\u00b112.7\u2009years, 86% men) were randomised. V\u0307O<jats:sub>2<\/jats:sub> max was comparable in both groups at 12\u2009weeks and REMOTE-CR was non-inferior to CBexCR (REMOTE-CR-CBexCR adjusted mean difference (AMD)=0.51 (95% CI \u22120.97 to 1.98)\u2009mL\/kg\/min, p=0.48). REMOTE-CR participants were less sedentary at 24\u2009weeks (AMD=\u221261.5 (95% CI \u2212117.8 to \u22125.3) min\/day, p=0.03), while CBexCR participants had smaller waist (AMD=1.71 (95% CI 0.09 to 3.34)\u2009cm, p=0.04) and hip circumferences (AMD=1.16 (95% CI 0.06 to 2.27)\u2009cm, p=0.04) at 12\u2009weeks. No other between-group differences were detected. Per capita programme delivery (NZD1130\/GBP573 vs NZD3466\/GBP1758) and medication costs (NZD331\/GBP168 vs NZD605\/GBP307, p=0.02) were lower for REMOTE-CR. Hospital service utilisation costs were not statistically significantly different (NZD3459\/GBP1754 vs NZD5464\/GBP2771, p=0.20).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>REMOTE-CR is an effective, cost-efficient alternative delivery model that could\u2014as a complement to existing services\u2014improve overall utilisation rates by increasing reach and satisfying unique participant preferences.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2018-313189","type":"journal-article","created":{"date-parts":[[2018,8,27]],"date-time":"2018-08-27T10:15:20Z","timestamp":1535364920000},"page":"122-129","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":301,"title":["Effects and costs of real-time cardiac telerehabilitation: randomised controlled non-inferiority trial"],"prefix":"10.1136","volume":"105","author":[{"given":"Ralph","family":"Maddison","sequence":"first","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"},{"name":"National Institute for Health Innovation, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9755-7993","authenticated-orcid":false,"given":"Jonathan Charles","family":"Rawstorn","sequence":"additional","affiliation":[{"name":"Institute for Physical Activity and Nutrition, Deakin University, Geelong, Victoria, Australia"},{"name":"National Institute for Health Innovation, University of Auckland, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph A H","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Auckland City Hospital, Auckland, New 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