FEASIBILITY OF A HOME-BASED CARDIAC REHABILITATION PROGRAM AMONG ADULTS WITH CARDIOVASCULAR DISEASE: A PILOT STUDY

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS American journal of preventive cardiology Pub Date : 2024-09-01 DOI:10.1016/j.ajpc.2024.100770
Tim Bilbrey EP, MBA
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Abstract

Therapeutic Area

Rehabilitation

Background

Home-based cardiac rehabilitation (HBCR) has the potential to improve access to cardiac rehabilitation for patients recovering from acute cardiovascular disease (CVD). This study aims to assess the feasibility and initial impact of a technology-enabled HBCR program delivered by a multidisciplinary team to patients with CVD.

Methods

This prospective, single-arm study used a within-subject design. We recruited patients (age 40+) from the community with a CR-eligible diagnosis (stable angina pectoris, myocardial infarction, heart failure, etc.). All eligible and enrolled patients referred to the RecoveryPlus.Health (RPH) remote CR clinic in Roanoke, TX between May and August of 2023 were included. The care team provided guideline-concordant CR services to study participants via two modalities: 1) synchronous telehealth exercise training via video conferencing; and 2) asynchronous mHealth virtual coaching app. Baseline survey and electronic health record (EHR) data were used to extract sociodemographic and clinical data. Feasibility was measured by program completion rate and CR service use. Preliminary efficacy was measured by changes in 6-minute walk test (6MWT), resting heart rate, and quality of life (SF-12) before and after the 12-week program. Paired t tests were used to examine the changes in the outcome variables post intervention.

Results

A total of 75 patients consented and were enrolled in the study. The average age was 64.2 (SD=10.3, Range: 45-85) and 50.7% were female. The most frequent referring diagnosis was heart failure (49.3%). 62 (82.7%) participants completed the 12-week study. Among those who completed the study, all patients attended the telehealth sessions and 60 (95.2%) used the mHealth App. Post intervention, participants on average improved their 6MWT by 40.0 meters (ES=0.632, 95% CI: 0.356 to 0.877), indicating better cardiorespiratory endurance. The physical and mental summary scores were also improved by 2.7 (ES=0.413) and 2.2 (ES=0.244), respectively. There were no differences in resting heart rate and no serious program-related adverse events were reported.

Conclusions

The pilot data showed that the HBCR program was feasible in delivering remote CR care to patients at home. The promising preliminary results suggest that a randomized controlled efficacy trial is warranted.
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在患有心血管疾病的成年人中开展家庭心脏康复计划的可行性:试点研究
治疗领域康复背景基于家庭的心脏康复(HBCR)有望改善急性心血管疾病(CVD)康复患者获得心脏康复的机会。本研究旨在评估由多学科团队为心血管疾病患者提供的技术辅助型 HBCR 项目的可行性和初步影响。我们从社区招募了符合 CR 诊断条件(稳定型心绞痛、心肌梗死、心力衰竭等)的患者(40 岁以上)。2023 年 5 月至 8 月期间,所有符合条件并转诊至德克萨斯州罗阿诺克市 RecoveryPlus.Health (RPH) 远程 CR 诊所的患者均被纳入其中。护理团队通过两种方式为研究参与者提供与指南一致的 CR 服务:1)通过视频会议进行同步远程医疗运动训练;2)异步移动医疗虚拟教练应用程序。基线调查和电子健康记录(EHR)数据用于提取社会人口学和临床数据。可行性通过项目完成率和 CR 服务使用情况来衡量。初步疗效通过 12 周计划前后 6 分钟步行测试 (6MWT)、静息心率和生活质量 (SF-12) 的变化来衡量。采用配对 t 检验来检测干预后结果变量的变化。平均年龄为 64.2 岁(SD=10.3,范围:45-85),50.7% 为女性。最常见的转诊诊断是心力衰竭(49.3%)。62名参与者(82.7%)完成了为期12周的研究。在完成研究的参与者中,所有患者都参加了远程保健课程,60 人(95.2%)使用了移动医疗应用程序。干预后,参与者的 6MWT 平均提高了 40.0 米(ES=0.632,95% CI:0.356 至 0.877),表明心肺耐力有所提高。体能和智能总分也分别提高了 2.7 分(ES=0.413)和 2.2 分(ES=0.244)。结论试点数据显示,HBCR 计划在为患者提供家庭远程 CR 护理方面是可行的。令人鼓舞的初步结果表明,有必要进行随机对照疗效试验。
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来源期刊
American journal of preventive cardiology
American journal of preventive cardiology Cardiology and Cardiovascular Medicine
CiteScore
6.60
自引率
0.00%
发文量
0
审稿时长
76 days
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