7.1.2 Review question: What is the clinical and cost effectiveness of home-based versus centre- based rehabilitation (that includes an exercise element) for people with heart failure (HF)? For full details see review protocol in appendix A. Table 74: PICO characteristics of review question Population People diagnosed with HF Intervention Home-based cardiac rehabilitation (CR) service. Programme must be structured, with clear objectives for the participants, and include a monitoring component. Programmes will be included whether they are based solely on exercise or include such as education and/or psychological support other intervention elements (comprehensive cardiac rehabilitation). No minimum duration of intervention. Comparison Centre-based CR service (including community based rehabilitation service and hospital based rehabilitation service). Programme must be structured, with clear objectives for the participants, and include a monitoring component. Programmes will be included whether they are based solely on exercise or include other intervention elements such as education and/or psychological support ( comprehensive CR ). Outcomes CRITICAL All-cause mortality CV mortality Health-related quality of life All cause hospitalisation HF-related hospitalisation IMPORTANT Exercise capacity Chronic Heart Failure Rehabilitation in chronic heart failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 Adverse events (withdrawal from the exercise programme) Adherence (including maintenance of exercise/physical activity) Health service use Study design RCTs (individual or cluster level, including parallel group, cross-over or quasi- randomised designs). 7.1.3 Clinical evidence The following review was conducted by the University of Exeter Medical School Cochrane Cardiac Rehabilitation group as part of a second update to the Cochrane systematic review Home versus centre-based Cardiac Rehabilitation 13 in accordance with NGC methodology. A search was conducted for randomised trials directly comparing home- with centre-based cardiac rehabilitation for people with heart failure. these are summarised in Table 75 below. 