Abstract 14769: Outcomes of a Smartphone-based Application With Live Health-coaching Post-percutaneous Coronary Intervention
Introduction: The period between inpatient hospitalization for symptomatic CAD and post-discharge office consultation remains a vulnerable interval for adverse outcomes. Tools to help guide patients during this susceptible time are needed. Methods: We customized content on a digital health platform for hospitalized patients receiving PCI which included education, tracking, reminders and health coaches. We conducted a single-arm open-label pilot study of the application (app) to test feasibility and efficacy at two academic medical centers with 1:3 propensity-matched historical controls (NCT03416920). We assessed whether the app led to excess 30-day hospital readmission, improved outpatient cardiovascular follow up (CVFU) and increased cardiac rehabilitation (CR) enrollment in our health system (MGB). Differences were assessed by Cox Proportional Hazards model. Results: 118 of 324 eligible (36.4%) were enrolled during incident PCI admission 02/18-06/19. 68 of 118 (57.6%) underwent PCI for MI. Mean age was 62.4 (9.7) years, 87 (73.7%) were male, 40 (33.9%) had DM2, and 59 (50.0%) had previously known CAD. There was no significant difference in all-cause readmission within 30 or 90 days. However, rates of both 90-day CR enrollment and 1-month CVFU were increased. App engagement was high – mean 47% daily and 63% weekly engagement within the first 90 days. Spearman correlation analyses indicated similar engagement across age, sex, and cardiovascular risk factors. Conclusions: A post-PCI smartphone app, with live health coaches, deployed upon discharge is feasible with similar engagement across demographics. Compared to historical controls, use of the app did not affect short-term hospital readmission but was associated with two-fold increased attendance in CR. Prospective randomized controlled trials are necessary to test the hypothesis that this digital health platform post-PCI improves cardiovascular outcomes over longer follow-up.