Development of Various Types and Forms of Messages for Smartphone-Based Cardiac Rehabilitation for Secondary Prevention in Patients with Coronary Artery Disease (Preprint)

2020 ◽  
Author(s):  
Eung Ju Kim ◽  
Jah Yeon Choi ◽  
Ji Bak Kim ◽  
Sunki Lee ◽  
Seo-Joon Lee ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Secondary Prevention ◽  
Cardiac Rehabilitation ◽  
Transtheoretical Model ◽  
Clinical Benefit ◽  
Cardiovascular Health ◽  
Unmet Need ◽  
Smartphone Application ◽  
General Information ◽  
Patient Specific

BACKGROUND Despite strong evidence of clinical benefit, cardiac rehabilitation (CR) programs are currently underutilized and smartphone-based CR strategies are thought to address this unmet need. However, the previous applications have several limitations and there are scarce data regarding its usefulness and clinical benefit. The application for self-improvement (AnSim) trial is a multicenter, prospective randomized trial to explore the feasibility and efficacy of smartphone-based messaging application for patients who underwent percutaneous coronary intervention (PCI). OBJECTIVE The current study will focus on the development of a smartphone-based, patient-specific messaging application and detailed design of the trial. METHODS The AnSim application is developed by multidisciplinary team collaboration including cardiologists, psychiatrists, nurses, pharmacists, nutritionists, and rehabilitation doctor and therapists. First, the focus group interview was conducted and narratives of the patients were analyzed to identify their needs and preferences. Based on the results, health care experts and clinicians drafted messages into 5 categories: (1) general information regarding cardiovascular health and medications, (2) nutrition, (3) physical activity, (4) destressing, and (5) smoking cessation. In each category, 30 messages were developed according to three simplified steps of the transtheoretical model of behavioral change: (1) pre-contemplation, (2) contemplation and preparation, and (3) action and maintenance. After internal review and feedback from potential users, a bank of 450 messages and application were finally developed. RESULTS The focus interview was performed with 8 patients with recent PCI within 1 month and development of 450 messages were done. Positive feedback obtained from the potential users (n = 200) that Likert scale score was 3.95±SD and 3.91±SD for readability and usefulness, respectively. Based on the results, the several messages were refined. Furthermore, messages using various forms of multimedia such as exercise videos and dietary regimens, and connection for smoking cessation center were also developed as needed. CONCLUSIONS A final bank of 450 smartphone-based, patient-specific messages were developed to support behavior change and decrease cardiovascular risk factors through 5 step iterative process. The detailed process of multidisciplinary collaboration in the course of the study provides a scientific basis for various medical professionals who are planning smartphone based clinical research and AnSim trial will demonstrate the feasibility and efficacy of a patient-specific messaging smartphone application in secondary prevention of coronary heart disease.

scholarly journals Design, development and randomised controlled trial of a smartphone application, ‘QinTB’, for smoking cessation in tuberculosis patients: study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031204 ◽  
Author(s):  
Haoxiang Lin ◽  
Yan Lin ◽  
Yunting Zheng ◽  
Zhao Liu ◽  
Chun Chang
Keyword(s):  
Smoking Cessation ◽  
Randomised Controlled Trial ◽  
Transtheoretical Model ◽  
Controlled Trial ◽  
Smartphone Application ◽  
Mobile Technologies ◽  
Design Development ◽  
Clinical Trial Registry ◽  
Quit Smoking ◽  
Randomised Controlled

IntroductionProviding smoking cessation treatment is an important intervention for tuberculosis (TB) patients. Mobile technologies, such as smartphone applications, have shown promising potential. However, there are few effective applications that could support TB patients in their efforts to quit smoking. To address this problem, we will develop a smartphone application ‘QinTB’ to help TB patients quit smoking, and we will evaluate the clinical efficacy of this application by using a randomised controlled trial (RCT).Methods and analysisThis is a two-step study. In the first step, we will develop a smartphone application based on an interactive application of the transtheoretical model and protection motivation theory. Then, we will perform an RCT using a two-arm design; a total of 400 patients will be randomly assigned to the application group or the doctors’ advice group; both treatments will be 6 months and follow-up will be 12 months; the primary outcome is the biochemically verified 6 month sustained abstinence rate; data will be analysed on an intention-to-treat basis.Ethics and disseminationThis study was approved by the Ethics Committee of Beijing Research Institute for Tuberculosis Control and Prevention. We will disseminate the findings of this study through peer-reviewed publications and conference presentations.Trial registration numberThis study was registered in the Chinese Clinical Trial Registry (ChiCTR1900022008) and the stage is Pre-results.

National quality indicators to promote cardiac rehabilitation service effectiveness in Australia

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Gallagher ◽  
C Astley ◽  
E Thomas ◽  
R Zecchin ◽  
C Ferry ◽  
...  
Keyword(s):  
Cardiac Rehabilitation ◽  
Quality Indicators ◽  
Business Models ◽  
Cardiovascular Health ◽  
National Level ◽  
Clinical Effectiveness ◽  
Rehabilitation Service ◽  
Service Improvement ◽  
Consistency Checking ◽  
National Quality

Abstract Background/Introduction Comprehensive exercise-based cardiac rehabilitation (CR) has well-established efficacy and effectiveness for improving patients' outcomes. There is substantial variability in terms of clinical effectiveness and quality measurement of CR programs internationally which limits service improvement initiatives. In Australia in 2018 a the Australian Cardiovascular Health and Rehabilitation Association (ACRA) and the National Heart Foundation of Australia (NHFA) combined forces to develop nationally-agreed, internationally-consistent, locally-relevant quality indicators (QI). Purpose To provide a minimum set of standardised national-level QI that should be collected and reported on by CR programs to determine the quality of delivery and associated outcomes, benchmark performance and support improvement processes. Methods We formed the National Cardiac Rehabilitation Measurement (NCRM) Taskforce led by ACRA and NHF and used the National Institute for Health and Care Excellence (NICE) UK guidelines to develop high quality QIs. The process included topic overview, prioritising areas for quality improvement, drafting and consultation, validation and consistency checking. Results Eleven preliminary QIs were circulated for ranking and comment to all ACRA members (predominately multidisciplinary CR providers) (68 responses), and to leading national multidisciplinary CR experts from cardiology, research, physiotherapy, nursing, epidemiology and register backgrounds (7 responses). Ratings, comments and suggestions were collated and discussed by the NCRM Taskforce, and the indicators rated most important, useful and feasible were retained, resulting in 10 QIs. These 10 QIs were presented at the ACRA national conference and then discussed at a workshop (55 participants) for this purpose. Ten QIs and accompanying data dictionary with definitions, evidence and allowable values is the final product. Conclusions A minimum set of locally relevant, internationally recognised, national QIs for CR is now available for CR providers, health service managers and researchers in Australia, which may be relevant internationally. The QIs will best serve national interests incorporated within a national cardiac registry but will also be useful for site audits and have strong potential to be aggregated across sites, health districts and states. The definitive test of the QIs will be how useful they are for CR program coordinators and funders of such programs; a key consideration for building sustainable business models and ensuring long-term implementation. Funding Acknowledgement Type of funding source: None

scholarly journals Home-based Cardiac Rehabilitation: the patients claim for new strategies but do they adhere?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
P Alves Da Silva ◽  
I Aguiar-Ricardo ◽  
N Cunha ◽  
T Rodrigues ◽  
B Valente-Silva ◽  
...  
Keyword(s):  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Cardiovascular Health ◽  
Training Session ◽  
Educational Status ◽  
Drop Out ◽  
Therapeutic Adherence ◽  
Validated Questionnaire ◽  
Home Based ◽  
Degree Of Participation

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac rehabilitation (CR) programs are established interventions to improve cardiovascular health, despite asymmetries in referral. With covid 19 outbreak, cardiac rehabilitation home based (CR-HB) programs emerged as an alternative. However, its adherence and implementation may vary greatly with socio-demographic factors. Purpose To assess adherence to the various components of a CR-HB program.  Methods Prospective cohort study which included patients (pts) who were participating in a centre-based CR program and accepted to participate in a CR-HB after the centre-based CR program closure due to COVID-19. The CR-HB consisted in a multidisciplinary digital CR program, including: 1.patient clinical and exercise risk assessment; 2.psychological tele-appointments; 3. online exercise training sessions; 4.structured online educational program for patients and family members/caregivers;  5. follow-up questionnaires; 6. nutrition tele-appointments; 7. physician tele-appointments Adherence to the program was assessed by drop-out rate; number of exercise sessions in which each patient participated; number of educational sessions attended and a validated questionnaire on therapeutic adherence (composed of 7 questions with minimum punctuation of 7 and maximum of 40 points). Results 116 cardiovascular disease (CVD) pts (62.6 ± 8.9 years, 95 males) who were attending a Centre-based CR program were included in a CR-HB program. Almost 90% (n = 103) of the participants had coronary artery disease; 13.8% pts had heart failure; the mean LVEF was 52 ± 11%. Regarding risk factors, obesity was the most common risk factor (74.7 %) followed by hypertension (59.6%), family history (41.8%), dyslipidaemia (37.9%), diabetes (18.1%), and smoking (12.9%).  Ninety-eight pts (85.5%) successfully completed the program. Almost half (46.9%) of the participants did at least one online exercise training session per week. Among the pts who did online exercise training sessions, 58% did 2-3 times per week, 27% once per week and 15% more than 4 times per week.  The pts participated, on average, in 1.45 ± 2.6 education sessions (rate of participation of 13,2%) and therapeutic adherence was high (39,7 ± 19; min 35-40).  Regarding educational status of the pts, 33 pts (45,2%) had a bachelor degree. These pts tended to participate more in exercise sessions (1,7 ± 1,7 vs 1,2 ± 1,4 sessions per week) and in education sessions (2.13 vs 1.6), although this difference was not statistically significant. The therapeutic adherence did not vary with patients’ level of education.  Conclusion Our results showed that a high percentage of patients completed the program and almost half were weekly physically active. However, in regard to educational sessions, the degree of participation was much lower. Educational status seemed to correlate with a higher degree of participation and, in the future, patient selection might offer better results in these kinds of programs.

Cardiac rehabilitation during COVID-19 pandemic – new challenges, new opportunities

2021 ◽  
Vol 14 (3) ◽  
pp. 215-221
Author(s):  
Maciej Janiszewski ◽  
Artur Mamcarz
Keyword(s):  
Secondary Prevention ◽  
Cardiac Rehabilitation ◽  
Second Phase ◽  
Mortality And Morbidity ◽  
Rehabilitation Programs ◽  
Rehabilitation Centers ◽  
New Challenges ◽  
Artery Disease

The role of comprehensive cardiac rehabilitation (CCR) is well established in the secondary prevention of cardiovascular diseases such as coronary artery disease and heart failure. Many clinical trials demonstrated effectiveness of CCR in improving exercise capacity, quality of life, and in reducing cardiovascular mortality and morbidity. However, even before the era of the COVID-19 pandemic comprehensive cardiac rehabilitation program’s implementation, especially the second phase, had many barriers. One of the main reasons for not attending in second phase of CCR was lack of transportation from patient’s home to rehabilitation centers. Additionally, in recent months COVID-19 pandemic has led to closure of many cardiac rehabilitation centres resulting in many eligible patients unable to participate in the optimisation of secondary prevention. During the coronavirus disease-2019 pandemic, hybrid telerehabilitation has become the leading solution in the cardiac rehabilitation programs. The present paper contains key information about structures, effectives and safety of hybrid telerehabilitation during the COVID-19 era.

scholarly journals Evitapp: Persuasive Application for Physical Activity and Smoking Cessation

Proceedings ◽  
2018 ◽  
Vol 2 (19) ◽  
pp. 1208 ◽  
Author(s):  
Antonio Bascur ◽  
Pedro Rossel ◽  
Valeria Herskovic ◽  
Claudia Martínez-Carrasco
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Smoking Cessation ◽  
Mobile Application ◽  
Cardiovascular Health ◽  
Sedentary Lifestyle ◽  
Smoking Habit ◽  
Tracking Devices

The most important risk factors for cardiovascular health are smoking and a sedentary lifestyle. This paper proposes Evitapp, a mobile application designed to promote physical activity and smoking cessation. The application does not use additional tracking devices, rather relying on phone sensors to track physical activity, and on users logging their behavior. Nineteen users tested the application over 10 days. Participants found the applications easy to use and used them approximately once per day. Even though the habits of the experiment participants did not change significantly, those who used the smoking cessation application reported decreasing their smoking habit.

Sign in / Sign up

Export Citation Format

Share Document