Thirty-six RCTs (8,297 participants) were included. One trial had 1,376 participants and others ranged from 15 to 792 participants; 20 trials included fewer than 150 participants.
Methodological quality of trials was low to moderate, 10 scored 1, 14 scored 2 and 12 scored 3 on the Jadad scale (maximum available was 5). In 24 trials the method of randomisation was either unclear or not appropriate. Only nine trials described an adequate method of allocation concealment. Nine trials did not clearly describe the comparator group treatment.
Compared to usual care, home-based intervention had no statistically significant effect on mortality (I2=0%, four trials) and cardiovascular events (I2=0%, five trials). Five trials reported on quality of life, the summative mean difference indicated a benefit with home-based intervention (SMD 0.23, 95% CI 0.02 to 0.45). Significant improvements in quality of life were evident with shorter term trials and not with longer term trials.
Compared to cardiac rehabilitation, home-based intervention had no statistically significant effect on mortality (I2=0%, six trials) and cardiovascular events (I2=89.7%, three trials). For cardiovascular events, one trial reported a statistically significant benefit with home-based intervention and two did not. One trial showed a significant improvement in quality of life with home based intervention. Overall there was no statistically significant effect on quality of life (five trials).
Compared to usual care there were statistically significant benefits for risk factors (systolic blood pressure, cholesterol levels, smoking cessation and depression scores) with home-based intervention. There were no statistically significant differences when compared to cardiac rehabilitation (full results reported). There was evidence of statistical heterogeneity for some risk factor results.