How has technology been used to deliver cardiac rehabilitation during the COVID-19 pandemic? An international cross-sectional survey of healthcare professionals conducted by the BACPR

BMJ Open. 2021 Apr 20;11(4):e046051. doi: 10.1136/bmjopen-2020-046051.


Objective: To investigate whether exercise-based cardiac rehabilitation services continued during the COVID-19 pandemic and how technology has been used to deliver home-based cardiac rehabilitation.

Design: A mixed methods survey including questions about exercise-based cardiac rehabilitation service provision, programme diversity, patient complexity, technology use, barriers to using technology, and safety.

Setting: International survey of exercise-based cardiac rehabilitation programmes.

Participants: Healthcare professionals working in exercise-based cardiac rehabilitation programmes worldwide.

Main outcome measures: The proportion of programmes that continued providing exercise-based cardiac rehabilitation and which technologies had been used to deliver home-based cardiac rehabilitation.

Results: Three hundred and thirty eligible responses were received; 89.7% were from the UK. Approximately half (49.3%) of respondents reported that cardiac rehabilitation programmes were suspended due to COVID-19. Of programmes that continued, 25.8% used technology before the COVID-19 pandemic. Programmes typically started using technology within 19 days of COVID-19 becoming a pandemic. 48.8% did not provide cardiac rehabilitation to high-risk patients, telephone was most commonly used to deliver cardiac rehabilitation, and some centres used sophisticated technology such as teleconferencing.

Conclusions: The rapid adoption of technology into standard practice is promising and may improve access to, and participation in, exercise-based cardiac rehabilitation beyond COVID-19. However, the exclusion of certain patient groups and programme suspension could worsen clinical symptoms and well-being, and increase hospital admissions. Refinement of current practices, with a focus on improving inclusivity and addressing safety concerns around exercise support to high-risk patients, may be needed.

Keywords: COVID-19; adult cardiology; rehabilitation medicine; telemedicine.

MeSH terms

  • COVID-19*
  • Cardiac Rehabilitation*
  • Cross-Sectional Studies
  • Delivery of Health Care
  • Humans
  • Pandemics
  • SARS-CoV-2
  • Technology