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Updated: Sep 28, 2026
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
A randomized controlled trial of an extensive lifestyle management intervention (ELMI) following cardiac
Scott A Lear1, Andrew Ignaszewski, Wolfgang Linden
1School of Kinesiology, Simon Fraser University, Burnaby, Canada. slear@providencehealth.bc.ca
Insights
The Extensive Lifestyle Management Intervention (ELMI) trial investigates a post-cardiac rehabilitation program to prevent deterioration of risk factors and lifestyle behaviors. Results will inform future cardiac rehabilitation program designs.
Area of Science:
- Cardiology
- Public Health
- Behavioral Science
Background:
- Standard cardiac rehabilitation programs (CRP) are limited to four months.
- Risk factors and lifestyle behaviors may worsen after CRP completion.
- The Extensive Lifestyle Management Intervention (ELMI) trial aims to prevent adverse changes post-CRP.
Purpose of the Study:
- To investigate the benefits of a randomized intervention following standard CRP.
- To prevent deterioration of risk factors and lifestyle behaviors in patients with ischemic heart disease (IHD).
Main Methods:
- Patients with IHD were randomized post-CRP to ELMI or usual care.
- ELMI involved case management, individualized risk factor/lifestyle management, and counseling.
- Outcomes assessed included IHD global risk, cardiovascular events, healthcare utilization, and lifestyle adherence.
Main Results:
- 302 participants (29% of screened) were randomized over 28 months.
- Participants averaged 64 years, 18% women, with high rates of prior myocardial infarction and revascularization.
- Ischemic heart disease risk factors improved significantly post-CRP, with similar baseline characteristics between groups.
Conclusions:
- The study population is representative of patients completing standard CRP.
- Results from the ELMI trial will offer valuable insights for future CRP development.
- The findings will guide the design of more effective, long-term cardiac care interventions.
Background:
Cardiac rehabilitation programs (CRP) represent comprehensive interventions that are typically limited to four months. Following completion of CRP, it appears that risk factors and lifestyle behaviours may deteriorate. The Extensive Lifestyle Management Intervention (ELMI) Following Cardiac Rehabilitation trial will investigate the benefits of a randomized intervention to prevent these adverse changes.
Methods:
Patients with ischemic heart disease (IHD) were randomized following a standard CRP to the ELMI or to usual care. The ELMI program is a case-managed intervention aimed at individualizing risk factor and lifestyle management based on current treatment guidelines. The program consists of cardiac rehabilitation sessions, telephone follow-up and risk factor and lifestyle counselling sessions. Health professionals work with participants using behavioural counselling and communications with participants' family physicians. Usual care participants return to their family physicians' care, and come to the study clinic only to undergo annual outcomes assessment. The primary outcome is change in IHD global risk after four years. Secondary outcomes include combined cardiovascular events, health care utilization, lifestyle adherence, quality of life and risk factors.
Results:
Over 28 months, 302 men and women were randomized. This represented 29% of the total population screened. The average age of study participants is 64 years, 18% are women, 53% have had a previous myocardial infarction, 73% have undergone previous revascularization and 20% have diabetes mellitus. Ischemic heart disease risk factors for the entire cohort improved significantly after subjects had gone through previous CRPs. Baseline risk factors, lifestyle behaviours and medications were similar between the groups.
Conclusions:
This study population is representative of patients completing a standard CRP. Results of the ELMI trial will provide valuable information for the future design of CRPs.
