Experience of coronary heart disease patients with a nurse-led eHealth cardiac rehabilitation: Qualitative process evaluation of a randomized controlled trial

Su, Jing Jing; Paguio, Jenniffer Torralba; Baratedi, William Mooketsi; Abu‐Odah, Hammoda; Baťalík, Ladislav

doi:10.1016/j.hrtlng.2022.10.005

Cited by 19 publications

(35 citation statements)

References 29 publications

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“…In this regard, some studies have reported further improvements in quality-of-life parameters and promoting lifestyle-related CR interventions based on eHealth. 40 - 44 Most studies included in this systematic review found strong evidence that exercise-based telehealth CR is cost-effective. Compared to CBCR, there were no major differences, except for three studies evaluating a significant difference in average cost per patient and intervention costs in favor of telehealth CR.…”

Section: Discussionmentioning

confidence: 97%

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

Baťalík

Filáková

Sladeckova

et al. 2023

Eur J Phys Rehabil Med

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INTRODUCTION Alternatives such as remotely delivered therapy in the home environment or telehealth represent an opportunity to increase overall cardiac rehabilitation (CR) utilization. Implementing alternatives into regular practice is the next step in development; however, the cost aspect is essential for policymakers. Limited economic budgets lead to cost-effectiveness analyses before implementation. They are appropriate in cases where there is evidence that the compared intervention provides a similar health benefit to usual care. This systematic review aimed to compare the cost-effectiveness of exercise-based telehealth CR interventions compared to standard exercise-based CR. EVIDENCE ACQUISITION PubMed and Web of Science databases were systematically searched up to August 2022 to identify randomized controlled trials assessing patients undergoing telehealth CR. The intervention was compared to standard CR protocols. The primary intent was to identify the cost-effectiveness. Interventions that met the criteria were home-based telehealth CR interventions delivered by information and communications technology (telephone, computer, internet, or videoconferencing) and included the results of an economic evaluation, comparing interventions in terms of cost-effectiveness, utility, costs and benefits, or cost-minimization analysis. The systematic review protocol was registered in the PROSPERO Registry (CRD42022322531). EVIDENCE SYNTHESIS Out of 1525 identified studies, 67 articles were assessed for eligibility, and, at the end of the screening process, 12 studies were included in the present systematic review. Most studies (92%) included in this systematic review found strong evidence that exercise-based telehealth CR is cost-effective. Compared to CBCR, there were no major differences, except for three studies evaluating a significant difference in average cost per patient and intervention costs in favor of telehealth CR. CONCLUSIONS Telehealth CR based on exercise is as cost-effective as CBCR interventions. Funding telehealth CR by third-party payers may promote patient participation to increase overall CR utilization. High-quality research is needed to identify the most cost-effective design.

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Section: Discussionmentioning

confidence: 97%

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

Baťalík

Filáková

Sladeckova

et al. 2023

Eur J Phys Rehabil Med

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“…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. …”

Section: Resultsmentioning

confidence: 99%

“…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…”

Section: Resultsmentioning

confidence: 99%

“…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…”

Section: Resultsmentioning

confidence: 99%

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

Jacobsson,

Oikarinen,

Krogell

et al. 2023

Clin Rehabil

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Objective To explore the extent and type of evidence in relation to group-based cardiac telerehabilitation interventions and health outcomes in coronary artery disease patients. Data sources A literature search was conducted in August 2022 and July 2023 in databases including PubMed, CINAHL, Scopus and PsycINFO. The search process followed the scoping review methodology guided by the Joanna Briggs Institute for scoping reviews. Methods The inclusion criteria were a peer-reviewed journal article published in English between 1 January 2017 and 15 August 2022 and updated to cover until 15 July 2023 concerning group-based cardiac telerehabilitation in adult coronary artery disease patients. All group-based cardiac telerehabilitation interventions and health outcome types were charted and summarized. Results The researcher screened a total of 2089 articles, of which 22 were retained with a total of 1596 participants. Group-based cardiac telerehabilitation interventions were particularly useful for patients with multi-faceted technological applications and social support. The patients received guidance regarding cardiovascular disease risk factors. Physical fitness, psychological complaints and quality of life were often measured outcomes in the included studies. Conclusions This scoping review indicates the success of various rehabilitation interventions utilizing different technologies for coronary patients. Coronary patients were guided in making lifestyle changes, and positive findings were observed in the health outcomes measured after the telerehabilitation intervention. The findings of this review can provide valuable guidance for developing and evaluating sustainable group-based cardiac telerehabilitation programs that aim to benefit coronary patients.

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“…Karen et al [ 61 ] found in the study of 172 patients with acute myocardial infarction that the HBCTR group significantly improved the patient's self-management ability, which was also confirmed by Maddison et al [ 62 ]. And in a descriptive qualitative study of 20 patients in the intervention group using the eHealth CR website, the results showed that telerehabilitation provides social support for changes in patients' cognitive determinants during the intervention [ 63 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of home-based cardiac telerehabilitation programs in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis

Zhang

et al. 2023

BMC Cardiovasc Disord

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Background Recent advances in telecommunications technology have raised the possibility of telehealth intervention delivering cardiac telerehabilitation, which may provide the efficacy of health services in patients after percutaneous coronary intervention (PCI). This study aimed to investigate the effects of home-based cardiac telerehabilitation (HBCTR) in patients undergoing PCI. Methods We performed a comprehensive search of the following electronic databases: PubMed, Cochrane Central, Web of Science, Embase, CNKI, and WANFANG. For the prespecified outcomes, the primary outcomes were results of physical function (the six-minute walking test, 6MWT) and quality of life (QoL) of the participants. The secondary outcomes were results of (1) blood pressure; (2) full lipid profile (3) reliable assessment of anxiety and depression in patients. Results All studies were conducted between 2013 and 2022, and a total of 5 articles could be included in the quantitative meta-analysis. The results showed that there was a statistically significant difference between the HBCTR intervention group and the control group in 6WMT (MD 16.59, 95%CI 7.13 to 26.06, P = 0.0006), but there was no difference in QoL (SMD − 0.25, 95%CI − 1.63 to 1.13, P = 0.73). According to the fixed effects model, there was a statistically significant difference between the HBCTR group versus the control group (MD − 2.88, 95%CI − 5.19 to − 0.57, P = 0.01), but not in diastolic blood pressure. Likewise, significant improvements of triglycerides and in low-density lipoprotein cholesterol were observed in HBTCR groups, but no significant differences were observed regarding total cholesterol and high-density lipoprotein cholesterol. Conclusion This systematic review and meta-analysis have proven that the HBCTR is one of the promisingly effective cardiac rehabilitation strategies that improve cardiorespiratory fitness and reduce cardiovascular disease risk factors. With the continuous improvement of the telerehabilitation network, it is expected to serve in clinical.

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Experience of coronary heart disease patients with a nurse-led eHealth cardiac rehabilitation: Qualitative process evaluation of a randomized controlled trial

Cited by 19 publications

References 29 publications

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review

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

Effects of home-based cardiac telerehabilitation programs in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis

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