Main Mechanisms of Remote Monitoring Programs for Cardiac Rehabilitation and Secondary Prevention: A SYSTEMATIC REVIEW.

IF 3.3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiopulmonary Rehabilitation and Prevention Pub Date : 2023-11-01 DOI:10.1097/HCR.0000000000000802
Alexander M Clark, Bailey J Sousa, Chantal F Ski, Julie Redfern, Lis Neubeck, Saleema Allana, Annette Peart, Danielle MacDougall, David R Thompson
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Abstract

Purpose: The objective of this report was to identify the main mechanisms of home-based remote monitoring programs for cardiac rehabilitation (RM CR) and examine how these mechanisms vary by context.

Methods: This was a systematic review using realist synthesis. To be included, articles had to be published in English between 2010 and November 2020 and contain specific data related to mechanisms of effect of programs. MEDLINE All (1946-) via Ovid, Embase (1974-) via Ovid, APA PsycINFO (1806-), CINAHL via EBSCO, Scopus databases, and gray literature were searched.

Results: From 13 747 citations, 91 focused on cardiac conditions, with 23 reports including patients in CR. Effective RM CR programs more successfully adapted to different patient home settings and broader lives, incorporated individualized patient health data, and had content designed specifically for patients in cardiac rehabilitation. Relatively minor but common technical issues could significantly reduce perceived benefits. Patients and families were highly receptive to the programs and viewed themselves as fortunate to receive such services. The RM CR programs could be improved via incorporating more connectivity to other patients. No clear negative effects on perceived utility or outcomes occurred by patient age, ethnicity, or sex. Overall, the programs were seen to best suit highly motivated patients and consolidated rather than harmed existing relationships with health care professionals and teams.

Conclusions: Remote monitoring CR programs are perceived by patients to be beneficial and attractive. Future RM CR programs should consider adaptability to different home settings, incorporate individualized health data, and contain content specific to patient needs.

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心脏康复和二级预防远程监测项目的主要机制:系统综述。
目的:本报告的目的是确定基于家庭的心脏康复远程监测计划(RM-CR)的主要机制,并研究这些机制如何因环境而异。方法:采用现实主义综合法进行系统综述。为了纳入,文章必须在2010年至2020年11月期间以英语发表,并包含与项目效果机制相关的具体数据。检索MEDLINE All(1946-)通过Ovid,Embase(1974-)通过O维德,APA PsycINFO(1806-),CINAHL通过EBSCO,Scopus数据库和灰色文献。结果:在13747次引用中,91次关注心脏病,23次报告包括CR患者。有效的RM CR计划更成功地适应了不同的患者家庭环境和更广泛的生活,纳入了个性化的患者健康数据,并具有专门为心脏康复患者设计的内容。相对较小但常见的技术问题可能会显著降低感知到的好处。患者和家属对这些项目非常接受,并认为自己很幸运能得到这样的服务。RM CR项目可以通过与其他患者的更多连接来改进。患者年龄、种族或性别对感知效用或结果没有明显的负面影响。总的来说,这些项目被认为最适合积极性高的患者,并巩固而不是损害与医疗保健专业人员和团队的现有关系。结论:远程监测CR程序被患者认为是有益的和有吸引力的。未来的RM CR计划应考虑对不同家庭环境的适应性,纳入个性化的健康数据,并包含特定于患者需求的内容。
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来源期刊
CiteScore
5.40
自引率
34.20%
发文量
164
审稿时长
6-12 weeks
期刊介绍: JCRP was the first, and remains the only, professional journal dedicated to improving multidisciplinary clinical practice and expanding research evidence specific to both cardiovascular and pulmonary rehabilitation. This includes exercise testing and prescription, behavioral medicine, and cardiopulmonary risk factor management. In 2007, JCRP expanded its scope to include primary prevention of cardiovascular and pulmonary diseases. JCRP publishes scientific and clinical peer-reviewed Original Investigations, Reviews, and Brief or Case Reports focused on the causes, prevention, and treatment of individuals with cardiovascular or pulmonary diseases in both a print and online-only format. Editorial features include Editorials, Invited Commentaries, Literature Updates, and Clinically-relevant Topical Updates. JCRP is the official Journal of the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation.
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