• Neil Heron, Frank Kee, Michael Donnelly, Christopher Cardwell, Mark A Tully, and Margaret E Cupples.
• NIHR clinical academic fellow in GP/sport and exercise medicine, Centre for Public Health, School of Medicine, Dentistry and Biomedical Science, Queen's University, Belfast; and The UK Clinical Research Collaboration, Centre of Excellence for Public Health (Northern Ireland), Institute of Clinical Science B, Royal Victoria Hospital, Belfast, UK.
• Br J Gen Pract. 2016 Oct 1; 66 (651): e747-57.

BackgroundCardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice.AimTo identify and describe the use of BCTs in home-based CR programmes.Design And SettingRandomised controlled trials of home-based CR between 2005 and 2015 were identified by searching MEDLINE(®), Embase, PsycINFO, Web of Science, and Cochrane Database.MethodReviewers independently screened titles and abstracts for eligibility. Relevant data, including BCTs, were extracted from included studies. A meta-analysis studied risk factor change in home-based and comparator programmes.ResultsFrom 2448 studies identified, 11 of good methodological quality (10 on post-myocardial infarction, one on heart failure, 1907 patients) were included. These reported the use of 20 different BCTs. Social support (unspecified) was used in all studies and goal setting (behaviour) in 10. Of the 11 studies, 10 reported effectiveness in reducing CVD risk factors, but one study showed no improvement compared to usual care. This study differed from effective programmes in that it didn't include BCTs that had instructions on how to perform the behaviour and monitoring, or a credible source.ConclusionSocial support and goal setting were frequently used BCTs in home-based CR programmes, with the BCTs related to monitoring, instruction on how to perform the behaviour, and credible source being included in effective programmes. Further robust trials are needed to determine the relative value of different BCTs within CR programmes.© British Journal of General Practice 2016.

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