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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Effectiveness of Mobile Health Augmented Cardiac Rehabilitation on Behavioural Outcomes among Post-acute Coronary
Saima Manzoor1, Aliya Hisam1, Sohail Aziz2
1Department of Community Medicine, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan.
Insights
Mobile health augmented cardiac rehabilitation (MCard) improved physical activity and healthy eating in post-acute coronary syndrome patients. This intervention shows promise for lasting behavior modification in this vulnerable group.
Area of Science:
- Cardiovascular Medicine and Health Technology
- Digital Health Interventions
Background:
- Post-acute coronary syndrome (ACS) patients require comprehensive rehabilitation to manage behavioral risk factors.
- Traditional cardiac rehabilitation programs may face challenges in long-term adherence and accessibility.
Purpose of the Study:
- To evaluate the effectiveness of a mobile health augmented cardiac rehabilitation (MCard) program.
- To assess the impact of MCard on key behavioral factors in patients recovering from ACS.
Main Methods:
- A randomized controlled trial was conducted involving post-ACS patients.
- The intervention group received MCard (counseling, text messages, standard care), while the control group received standard care.
- Behavioral factors including healthy eating, physical activity, medication compliance, smoking, and salt intake were assessed over six months.
Main Results:
- MCard significantly improved physical activity levels (MET scores) by 24 weeks (p=0.007).
- Significant improvements were observed in healthy eating habits (p<0.001) and reduced salt intake (p=0.008) at 24 weeks.
- No significant differences were found in medication compliance, smoking behavior, or self-monitoring of blood pressure and weight.
Conclusions:
- The MCard intervention demonstrates positive effects on physical activity, healthy eating, and salt restriction in post-ACS patients.
- MCard is a feasible and effective intervention for promoting lasting behavior modification in patients with cardiovascular disease.
- Mobile health strategies can enhance cardiac rehabilitation outcomes for vulnerable patient populations.
Objective:
To determine the effectiveness of mobile health augmented cardiac rehabilitation (MCard) on behavioural factors among post-acute coronary syndrome (post-ACS) patients.
Study Design:
Randomised controlled trial.
Place And Duration Of Study:
Armed Forces Institute of Cardiology (AFIC), from January 2019 till March 2021.
Methodology:
Post-ACS patients were assigned to one of two groups: intervention (counselling, brief text messages, and standard post-ACS care) or control (no intervention) (standard post-ACS care). Healthy eating (Healthy eating assessment tool) and physical activity (IPAQ tool), medication compliance, smoking, salt intake, blood pressure (BP), and weight self-monitoring were assessed as behavioural factors. Data were collected three times for a six-month follow-up period (baseline, 12 and 24 weeks).
Result:
At 12 weeks, 121 (76.62%) of the 160 patients enrolled patients (80 in each group) were analysed; and at 24 weeks, 119 (74.38%) were analysed. Mean MET score at baseline was 1170 control vs. 1161 intervention (p = 0.940), at 12 weeks 826 vs. 934 (p = 0.390); and at 24 weeks was 925 vs. 1454 (p = 0.007). Healthy eating value at baseline was 36.43 control vs. 36.38 intervention (p =0.897), at 12 weeks 38.76 vs. 40.98 (p<0.001); and at 24 weeks 40.12 vs. 43.54 (p <0.001). There was also a significant difference in salt intake (p = 0.008) and healthy diet (p = 0.012), but not in medicine compliance, smoking behaviour, self-monitoring of BP and weight.
Conclusion:
The MCard positively impacts the post-ACS participants' behaviours in terms of physical activity, healthy eating, and salt restriction. MCard evidenced as a feasible intervention in terms of having lasting behaviour modification among this vulnerable patient population. Key Words: Acute coronary syndrome, Myocardial infarction, Cardiovascular diseases, Cardiac rehabilitation, Healthy diet, Physical activity, Smoking, Tobacco, Telemedicine, Lifestyle modification.
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