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Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial
  1. Marlien Varnfield1,2,
  2. Mohanraj Karunanithi1,3,
  3. Chi-Keung Lee4,
  4. Enone Honeyman1,
  5. Desre Arnold4,
  6. Hang Ding1,
  7. Catherine Smith2,
  8. Darren L Walters3,5
  1. 1Australian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organisation, Brisbane, Queensland, Australia
  2. 2Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
  3. 3School of Medicine, University of Queensland, Brisbane, Queensland, Australia
  4. 4Complex Chronic Disease Team, North Lakes Health Precinct, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
  5. 5Department of Cardiology, The Prince Charles Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
  1. Correspondence to Marlien Varnfield, Australian eHealth Research Centre, Commonwealth Scientific and Industrial Research Organisation, Level 5, UQ Health Sciences Building, 901/16 Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4029, Australia; marlien.varnfield{at}csiro.au

Abstract

Objective Cardiac rehabilitation (CR) is pivotal in preventing recurring events of myocardial infarction (MI). This study aims to investigate the effect of a smartphone-based home service delivery (Care Assessment Platform) of CR (CAP-CR) on CR use and health outcomes compared with a traditional, centre-based programme (TCR) in post-MI patients.

Methods In this unblinded randomised controlled trial, post-MI patients were randomised to TCR (n=60; 55.7±10.4 years) and CAP-CR (n=60; 55.5±9.6 years) for a 6-week CR and 6-month self-maintenance period. CAP-CR, delivered in participants’ homes, included health and exercise monitoring, motivational and educational material delivery, and weekly mentoring consultations. CAP-CR uptake, adherence and completion rates were compared with TCR using intention-to-treat analyses. Changes in clinical outcomes (modifiable lifestyle factors, biomedical risk factors and health-related quality of life) across baseline, 6 weeks and 6 months were compared within, and between, groups using linear mixed model regression.

Results CAP-CR had significantly higher uptake (80% vs 62%), adherence (94% vs 68%) and completion (80% vs 47%) rates than TCR (p<0.05). Both groups showed significant improvements in 6-minute walk test from baseline to 6 weeks (TCR: 537±86–584±99 m; CAP-CR: 510±77–570±80 m), which was maintained at 6 months and showed slight weight reduction (89±20–88±21 kg) and also demonstrated significant improvements in emotional state (K10: median (IQR) 14.6 (13.4–16.0) to 12.6 (11.5–13.8)), and quality of life (EQ5D-Index: median (IQR) 0.84 (0.8–0.9) to 0.92 (0.9–1.0)) at 6 weeks.

Conclusions This smartphone-based home care CR programme improved post-MI CR uptake, adherence and completion. The home-based CR programme was as effective in improving physiological and psychological health outcomes as traditional CR. CAP-CR is a viable option towards optimising use of CR services.

Trial registration number ANZCTR12609000251224.

  • MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD)

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