Uptake of a technology‐assisted home‐care cardiac rehabilitation program

Abstract

The prevalence of cardiovascular disease, a major cause of disease burden in Australia and other developed countries, is increasing due to a rapidly ageing population and environmental, biomedical and modifiable lifestyle factors. Although cardiac rehabilitation (CR) programs have been shown to be beneficial and effective, rates of referral, uptake and utilisation of traditional hospital or community centre programs are poor. Home‐based CR programs have been shown to be as effective as centre‐based programs, and recent advances in information and communication technologies (ICT) can be used to enhance the delivery of such programs. The Care Assessment Platform (CAP) is an integrated home‐based CR model incorporating ICT (including a mobile phone and the internet) and providing all the core components of traditional CR (education, physical activity, exercise training, behaviour modification strategies and psychological counselling). The mobile phone given to patients has an integrated accelerometer and diary application for recording exercise and health information. A central database, with access to these data, allows mentors to assess patients’ progress, assist in setting goals, revise targets and give weekly personal feedback. Mentors find the mobile‐phone modalities practical and easy to use, and preliminary results show high usage rates and acceptance of ICT by participants. The provision of ICT‐supported home‐based CR programs may enable more patients in both metropolitan and remote settings to benefit from CR.

A mHealth cardiac rehabilitation exercise intervention: findings from content development studies

“…The high degree of support from patients and stakeholders confirmed the need for and acceptability of a mHealth CR program, which encouraged researchers to proceed with the six month RCT. These results reflect feedback collected from mentors and patients in earlier research evaluating the acceptability of delivering a 6 week CR program by mobile phone and internet [34]. …”

Development of Smartphone Applications for Nutrition and Physical Activity Behavior Change

“…Mattila et al used a wellness diary for recording self-management of weight-related behaviors [34], Hughes et al developed an app for monitoring energy balance [35], Lee et al developed a weight loss diet game [36], while others have monitored diet or physical activity as part of a program for diabetes [37] or cardiac rehabilitation [38]. The uptake and usage of these apps has been moderate to high among adults in the intervention setting [34,36-38]. Smartphone apps have the potential to improve population health, largely because of their widespread and increasing use, dynamic technological advancements, ability to download updates, and use of existing features (eg, Internet access, geopositioning technology, as well as photo, video, and voice recording capabilities), and the potential for reducing intervention delivery costs.…”

Using Mobile Technology for Cardiac Rehabilitation: A Review and Framework for Development and Evaluation

“…However, it appears that access and participation may be superior via a mobile platform. 38 All published and planned studies of the use of mobile technology for cardiac rehabilitation include some degree of tailoring the intervention to the individual, further highlighting the importance of tailoring in the design of mobile interventions for cardiac rehabilitation.…”

“…37,39 Ongoing studies suggest that mobile applications for cardiac rehabilitation can be highly usable, and that use may be promoted by automatic (preferably wireless) entry of data, such as objectively‐measured physical activity. 38 Further study is needed on the features of mobile phone applications for cardiac rehabilitation that promote usability, including the need for integration of sensors for ECG monitoring, physical activity monitoring (via accelerometer and global positioning system [GPS]), and measurement of heart rate, blood pressure, and blood glucose. We propose that formal evaluation of the usability of the mobile application be conducted with user‐testing and field studies to evaluate qualitative and quantitative measures of efficiency, effectiveness, and user satisfaction.…”