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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Remote Cardiac Rehabilitation With Wearable Devices
Atsuko Nakayama1,2, Noriko Ishii3, Mami Mantani3
1Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Insights
Remote cardiac rehabilitation (CR) offers a solution to low participation by using wearable devices for telemonitoring. While effective for exercise tolerance, its impact on preventing cardiac events and mortality requires further investigation.
Area of Science:
- Cardiology
- Digital Health
- Rehabilitation Medicine
Background:
- Outpatient cardiac rehabilitation (CR) improves outcomes but suffers from low patient participation due to logistical and personal barriers.
- Remote CR, utilizing wearable devices and telemonitoring, is emerging as a strategy to increase access and adherence to CR programs.
- Existing research confirms remote CR's benefits for exercise tolerance, but its effects on major cardiac events and mortality are less clear.
Purpose of the Study:
- To explore the potential and challenges of remote cardiac rehabilitation (CR) as an alternative to traditional outpatient programs.
- To review the current evidence on the effectiveness of remote CR, particularly concerning exercise tolerance and long-term cardiac outcomes.
- To identify key components for successful remote CR implementation, including risk stratification, telenursing, and multidisciplinary care.
Main Methods:
- Review of existing literature on remote CR programs and technologies.
- Analysis of studies evaluating the impact of remote CR on exercise capacity and patient adherence.
- Discussion of essential elements for safe and effective remote CR, such as patient selection and quality assurance of remote care.
Main Results:
- Remote CR, facilitated by wearable devices and telemonitoring applications, shows promise in improving exercise tolerance.
- The preventive effects of remote CR on cardiac events and mortality remain a subject of ongoing research and debate.
- Successful remote CR necessitates robust exercise risk stratification, skilled telenursing, and integrated multidisciplinary interventions.
Conclusions:
- Remote CR is a potential future component of cardiovascular disease management, addressing barriers to traditional CR.
- Ensuring the quality of telenursing and multidisciplinary interventions is crucial for the safety and efficacy of remote CR.
- Further research is needed to establish the cost-effectiveness and insurance coverage for widespread remote CR adoption.
Abstract:
Although cardiac rehabilitation (CR) has been shown to improve exercise tolerance and prognosis in patients with cardiovascular diseases, there remains low participation in outpatient CR. This may be attributed to the patients' busy schedules and difficulty in visiting the hospital due to distance, cost, avoidance of exercise, and severity of coronary disease. To overcome these challenges, many countries are exploring the possibility of remote CR. Specifically, there is increasing attention on the development of remote CR devices, which allow transmission of vital information to the hospital via a remote CR application linked to a wearable device for telemonitoring by dedicated hospital staff. In addition, remote CR programs can support return to work after hospitalization. Previous studies have demonstrated the effects of remote CR on exercise tolerance. However, the preventive effects of remote CR on cardiac events and mortality remain controversial. Thus, safe and effective remote CR requires exercise risk stratification for each patient, telenursing by skilled staff, and multidisciplinary interventions. Therefore, quality assurance of telenursing and multi-disciplinary interventions will be essential for remote CR. Remote CR may become an important part of cardiac management in the future. However, issues such as cost-effectiveness and insurance coverage still persist.
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