Digital Health Intervention as an Adjunct to Cardiac Rehabilitation Reduces Cardiovascular Risk Factors and Rehospitalizations

Abstract

Cardiac rehabilitation (CR) following myocardial infarction is vastly underused. As such the aim of this study was to test a digital health intervention (DHI) as an adjunct to CR. Patients undergoing standard Mayo Clinic CR were recruited prior to CR (n=25) or after three months CR (n=17). Changes in risk factors and rehospitalizations plus emergency department (ED) visits were assessed after three months. Patients assigned to DHI during CR had significant reductions in weight (−4.0+5.2 kg, P=.001), blood pressure (−10.8±13.5 mmHg, P=.0009), and the group using DHI after three months of CR had significant reductions in weight (−2.5±3.8 kg, P=.04) and systolic BP (−12.6±12.4 mmHg, P=.001) compared to the control groups. Both DHI groups also displayed significant reductions in rehospitalizations/ED visits (−37.9%, P=0.01 and −28%, P=.04, respectively). This study suggests that a guideline-driven, DHI CR program can augment secondary prevention strategies during usual CR by improving risk factors for repeat events.

Mobile Phone Interventions for the Secondary Prevention of Cardiovascular Disease

“…death, hospitalization, and emergency department visits), and none found any effect on these outcomes. 28,30,33–35 Our findings are consistent with other reviews that reported overall positive potential for mHealth technology to improve various behaviors and clinical outcomes in different populations. 17,46–50 Compared to others, our paper provided an updated search of focused text messaging and mobile apps interventions with clinical outcomes related to the secondary prevention of CVD.…”

“…Four RCTs and one observational study examined major clinical outcomes in HF, CHD, and stroke but they did not find significant differences in mortality, number of hospitalizations, or days in hospital between the experimental and control groups. 28,30,33–35 …”

“…Three of the studies using mobile apps were observational; 28,29,42 while the other three were randomized studies. 23,27,35 Two of these randomized studies combined mobile apps with other interventions, such as text messaging and telephone coaching.…”

“…35 Fifth, only 7 studies applied theory to support the development, testing, or implementation of the intervention. These theories included Health Belief Model, 41 Social Cognitive Theory, 22,25,44 Self-Efficacy Theory, 24 general behavioral change theory, 28 or a combination of multiple behavioral change theories. 18 Lastly, additional use of qualitative research methods will inform the design, implementation, and adherence of mHealth interventions that can be used on a long-term basis for chronic disease management.…”

Remote Patient Monitoring via Non-Invasive Digital Technologies: A Systematic Review

“…The health outcomes data reported were classified as mostly positive across all of the included studies. Key outcomes included self-management (i.e., taking blood pressure or tracking weight) shown to help symptoms severity and reduce patient visits and/or hospitalizations, 59,67,79 as well as quality of life improvement through activation of self-care behaviors. 22,66 …”