Physical Activity after Cardiac EventS (PACES) – a group education programme with subsequent text-message support designed to increase physical activity in individuals with diagnosed coronary heart disease: study protocol for a randomised controlled trial

Abstract

BackgroundCoronary heart disease (CHD) represents approximately 13% of deaths worldwide and is the leading cause of death in the UK with considerable associated health care costs. After a CHD event, timely cardiac rehabilitation optimises patient outcomes. However, a high percentage of these services do not meet necessary performance indicators such as course length and follow-up attendance. Uptake of such services is only 50% in UK patients and support provided 12 months after an event is often limited. To delay and prevent further CHD events leading to hospitalisation, supplementary self-management strategies such as group education, are necessary.MethodsThis is a single-centre, randomised controlled trial (RCT) recruiting participants (n = 290) aged ≥18 years who are 12 to 48 months post diagnosis of a CHD-related cardiac event (myocardial infarction, angina and any other acute coronary syndrome). The study aims to implement a structured education programme, with text-message support over 12 months, and identify whether delivery of the programme, to individuals who have a history of a cardiac event, would be an effective and cost-effective strategy for increasing walking. The primary outcome, objectively measured average daily physical activity, specifically step count through walking activity, is assessed using the wrist-worn GENEActiv accelerometer at baseline, 6 and 12 months. Secondary outcomes at 12 months include cardiovascular risk factors such as smoking status, blood pressure, lipid profile, glycated haemoglobin (HbA1c), obesity, self-efficacy, quality of life, physical activity and physical function.Participants are randomised to either the control group receiving standard care and a physical activity information leaflet, or the intervention group whose partcipants receive the leaflet and are invited to attend two group-based structured education sessions. These encourage participants to adopt and maintain healthy behaviours and self-manage their lifestyle. They are delivered approximately 2 weeks apart by trained facilitators and reinforced via subsequent text-message support.DiscussionTo our knowledge, this is the first trial designed to assess the effectiveness of a group education programme 12 to 48 months after a CHD event diagnosis. If successful, the PACES programme could be translated into effective post-operative cardiac care and complement the current post-operative services available.Trial registrationISRCTN, ID: ISRCTN91163727. The trial was registered on 27 February 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2923-x) contains supplementary material, which is available to authorized users.

The Associations between Mental Well-Being and Adherence to Physical Activity Guidelines in Patients with Cardiovascular Disease: Results from the Scottish Health Survey

“…al. [29] have reported that a high percentage of CVD patients—including patients with diabetes, cancer, and high blood pressure (BP)—do not achieve the recommended levels of PA. Zachariah et. al.…”

Physical Activity after Cardiac EventS (PACES): a group education programme with subsequent text message support designed to increase physical activity in individuals with diagnosed coronary heart disease: a randomised controlled trial

“…A single-centre RCT with two parallel arms, the protocol has been previously described. 7 Participants Participants were recruited from the University Hospitals of Leicester National Health Service (NHS) Trust Cardiology Department and Phase Four community cardiac rehabilitation providers between March 2017 and March 2018 (recruitment target reached). Eligible participants were aged ≥18 years, 12-48 months after a CHD cardiac event diagnosis (myocardial infarction, angina, acute coronary syndrome (ACS)), had mobile phone access, willing to allow their general practitioner (GP) notification of study participation and medical records access (study purposes), willing to attend education sessions and able to speak and read English.…”

Comparing the Impact of Three Follow-Up Methods (Telephone, Educational Booklet, and SMS) on Self-Care Ability of Patients with Acute Coronary Syndrome: A Quasi-Experimental Study

“…Passaglia et al (37) proposed that text messaging was effective in enhancing and controlling the risk factors in patients with ACS. Herring et al (38) confirmed the effect of SMS-based training on the physical activity of CHD patients. Also, in keeping with the present study, Safaie et al (39) suggested that texting could help promote adherence to treatment regimens among hypertensive patients.…”