Chinese Home-Based Cardiac Rehabilitation Model Delivered by Smartphone Interaction Improves Clinical Outcomes in Patients With Coronary Heart Disease

Abstract

Purpose: We evaluated the long-term effect of a smartphone-facilitated home-based cardiac rehabilitation (HBCR) model in revascularized patients with coronary heart disease (CHD) on major adverse cardiac events (MACE), and secondary outcomes, including safety, quality of life, and physical capacity.Methods: It was a prospective observational cohort study including a total of 335 CHD patients after successful percutaneous coronary intervention (PCI) referred to the CR clinic in China between July 23, 2015 and March 1, 2018. Patients were assigned to two groups: HBCR tailored by monitoring and telecommunication via smartphone app (WeChat) (HBCR group, n = 170) or usual care (control group, n = 165), with follow-up for up to 42 months. Propensity score matching was conducted to match patients in the HBCR group with those in the control group. The patients in the HBCR group received educational materials weekly and individualized exercise prescription monthly, and the control group only received 20-min education at baseline in the CR clinic. The primary outcome was MACE, analyzed by Cox regression models. The changes in the secondary outcomes were analyzed by paired t-test among the matched cohort.Results: One hundred thirty-five HBCR patients were matched with the same number of control patients. Compared to the control group, the HBCR group had a much lower incidence of MACE (1.5 vs. 8.9%, p = 0.002), with adjusted HR = 0.21, 95% CI 0.07–0.85, and also had reduced unscheduled readmission (9.7 vs. 23.0%, p = 0.002), improved exercise capacity [maximal METs (6.2 vs. 5.1, p = 0.002)], higher Seattle Angina Questionnaire score, and better control of risk factors.Conclusions: The Chinese HBCR model using smartphone interaction is a safe and effective approach to decrease cardiovascular risks of patients with CHD and improve patients' wellness.Clinical Trial Registration:http://www.chictr.org.cn, identifier: ChiCTR1800015042.

Group-based cardiac telerehabilitation interventions and health outcomes in coronary patients: A scoping review

“…18–39 The studies varied in research designs, including 11 randomized controlled trials, 18–20,23,26,27,30–33,35 five pilot studies, 21,24,25,28,36 two observational studies, 29,34 one case study, 22 one qualitative study, 37 one mixed-method study, 38 and one cross-sectional study. 39 The studies had been conducted in different locations: 11 of them in Europe, 18–20,22,28,31,33–36,39 six in Asia, 23,24,29,30,32,37 three in Australia, 25–27 and two in North America. …”

“…Patients participating in the group-based cardiac telerehabilitation were required to have their own, relevant technological equipment with Internet access (computer, telephone, and mobile connection). 18–39 A variety of other devices and applications were also used in the included studies (Supplemental Material Table 3). Out of the 22 studies, a chat feature was primarily utilized as a means of delivering the intervention in 15 studies, 21,22,24–27,29–32,34,35,37–39 telemonitoring, 18,20,24,28–30,32–37,39 and a virtual platform 21–25,28,30–32,34,35,37…”

“…18–39 A variety of other devices and applications were also used in the included studies (Supplemental Material Table 3). Out of the 22 studies, a chat feature was primarily utilized as a means of delivering the intervention in 15 studies, 21,22,24–27,29–32,34,35,37–39 telemonitoring, 18,20,24,28–30,32–37,39 and a virtual platform 21–25,28,30–32,34,35,37–39 were used in 14 studies, other mobile connections in 12 studies…”

“…The studies varied in research designs, including 11 randomized controlled trials, [18][19][20]23,26,27,[30][31][32][33]35 five pilot studies, 21,24,25,28,36 two observational studies, 29,34 one case study, 22 one qualitative study, 37 one mixed-method study, 38 and one cross-sectional study. 39 The studies had been conducted in different locations: 11 of them in Europe, [18][19][20]22,28,31,[33][34][35][36]39 six in Asia, 23,24,29,30,32,37 three in Australia, [25][26][27] and two in North America. 21,38 The target population of 21 of the studies was coronary artery disease patients with heart failure and in one study coronary artery disease patients and the patients' partners.…”

Coronary atherosclerosis progression in patients after coronary stenting, depending on a cardiology follow-up strategy

“…Данные литературы свидетельствуют о том, что телемедицинское наблюдение пациентов с ИБС способствует улучшению контроля ФР сердечнососудис тых заболеваний, приверженности пациентов к лечению, а также улучшению клинических исходов [7,8]. В одном из исследований, включившем 335 человек после перенесенного чрескожного коронарного вмешательства, было показано, что в группе телемедицинского наблюдения частота неблагоприятных сердечно-сосудистых событий, включая сердечно-сосудистую смерть и внеплановую коронарную реваскуляризацию, составила 1,5%, тогда как в группе контроля 8,9% [9]. В исследование Blasko A, et al, посвященное возможностям дистанционного наблюдения за пациентами, было включено 203 пациента после перенесенного инфаркта миокарда.…”