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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Digital health intervention during cardiac rehabilitation: A randomized controlled trial
R Jay Widmer1, Thomas G Allison1, Ryan Lennon2
1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Insights
Digital health interventions (DHI) combined with cardiac rehabilitation (CR) significantly improved weight loss in patients post-percutaneous coronary intervention for acute coronary syndrome. This approach may reduce emergency department visits and rehospitalizations, enhancing cardiovascular disease secondary prevention.
Area of Science:
- Cardiovascular Medicine
- Digital Health Interventions
- Cardiac Rehabilitation
Background:
- Digital health interventions (DHI) show promise for improving cardiovascular health markers.
- Their impact on hard cardiovascular (CV) outcomes, such as emergency department (ED) visits and rehospitalizations, requires further investigation.
- This study focuses on patients undergoing cardiac rehabilitation (CR) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).
Purpose of the Study:
- To determine if DHI, when added to standard CR, can reduce CV-related ED visits and rehospitalizations.
- To evaluate the effect of DHI on secondary prevention metrics in patients post-ACS and PCI.
Main Methods:
- Randomized controlled trial comparing standard CR (n=40) with CR plus DHI (n=40) for 3 months.
- DHI involved an online and smartphone platform for reporting diet/exercise and receiving lifestyle education.
- Data on CV-related ED visits, rehospitalizations, and secondary prevention metrics were collected at 180 days and 90 days, respectively.
Main Results:
- The DHI+CR group achieved significantly greater weight loss compared to the control group (-5.1±6.5 kg vs. -0.8±3.8 kg, P=.02).
- A non-significant trend towards reduced CV-related rehospitalizations and ED visits was observed in the DHI+CR group at 180 days (8.1% vs 26.6%; RR 0.30, P=.054).
- Baseline demographics were similar between the two groups.
Conclusions:
- Complementary DHI significantly enhances weight loss in patients undergoing CR after ACS.
- DHI may serve as an effective adjunct to CR for reducing CV-related ED visits and rehospitalizations.
- The findings suggest a potential role for DHI in improving secondary prevention of cardiovascular disease.
Background:
Digital health interventions (DHI) have been shown to improve intermediates of cardiovascular health, but their impact on cardiovascular (CV) outcomes has not been fully explored. The aim of this study was to determine whether DHI administered during cardiac rehabilitation (CR) would reduce CV-related emergency department (ED) visits and rehospitalizations in patients after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).
Methods:
We randomized patients undergoing CR following ACS and PCI to standard CR (n=40) or CR+DHI (n=40) for 3 months with 3 patients withdrawing from CR prior to initiation in the treatment arm and 6 in the control group. The DHI incorporated an online and smartphone-based CR platform asking the patients to report of dietary and exercise habits throughout CR as well as educational information toward patients' healthy lifestyles. We obtained data regarding ED visits and rehospitalizations at 180 days, as well as other metrics of secondary CV prevention at baseline and 90 days.
Results:
Baseline demographics were similar between the groups. The DHI+CR group had improved weight loss compared to the control group (-5.1±6.5 kg vs. -0.8±3.8 kg, respectively, P=.02). Those in the DHI+CR group also showed a non-significant reduction in CV-related rehospitalizations plus ED visits compared to the control group at 180 days (8.1% vs 26.6%; RR 0.30, 95% CI 0.08-1.10, P=.054).
Conclusions:
The current study demonstrated that complementary DHI significantly improves weight loss, and might offer a method to reduce CV-related ED visits plus rehospitalizations in patients after ACS undergoing CR. The study suggests a role for DHI as an adjunct to CR to improve secondary prevention of CV disease.
Trial Registration:
This trial is registered at clinicaltrials.gov (NCT01883050).
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