CARDIAC INPATIENTS ARE HIGHLY INTERESTED IN VIRTUAL CARDIAC REHABILITATION

Abstract

Therapeutic Area

Rehabilitation

Background

Cardiac rehabilitation (CR) improves cardiovascular health and decreases hospital readmissions; unfortunately, it is widely underused by patients. Digital health interventions offer a potential solution to increase participation in CR. However, patients’ interest and concerns regarding virtual CR have not been fully explored.

Methods

A Qualtrics survey was administered to cardiac inpatients in the progressive cardiac care unit at Johns Hopkins Hospital from 2020-2024. This study included English-speaking patients, >18 years of age who met medical eligibility for CR. One-way ANOVA, Chi-square, and Fisher's Exact test were used to assess differences in interest in engaging in virtual CR by age, sex, and race, respectively.

Results

A total of 150 cardiac inpatients were included: age 64 ± 13 years, 62% (93/150) male, 57% (85/150) White, and 41% (61/150) completing a 4-year degree or higher. 93% (139/150) of patients reported owning a smartphone. The patients reported that their primary barriers to CR participation were traveling to the CR center (49%, 73/150), costs/insurance coverage (29%, 44/150), and a tight schedule (28%, 42/150). Notably, the majority of patients (71%, 107/150) expressed interest in engaging in virtual CR. Interest in virtual CR did not differ by age (p=0.35) or sex (p=0.49); however, Black (90%, 46/51) and Asian (83%, 5/6) adults reported being more interested in virtual CR than White (61%, 52/85) adults (p<0.001). While 39% of patients (58/150) felt less safe exercising at home compared to a supervised center, 83% (48/58) of these patients reported they would feel more confident exercising at home if able to communicate by phone with specialized staff during training sessions. Additionally, 39% (58/150) of patients expressed concerns about decreased motivation training alone at home; however, 52% (30/58) of these patients felt group calls with other patients could enhance engagement.

Conclusions

Virtual CR may advance health equity by overcoming traditional barriers to participation, with the majority of patients, especially Black and Asian adults, expressing interest. High prevalence of smartphone ownership suggests this may be feasible. Virtual CR efforts should focus on addressing safety concerns and enhancing motivation via direct communication with staff and other patients.