In the Journals

Smartphone-enabled cardiac rehabilitation viable option for veterans with CHD

Smartphone-enabled, home-based cardiac rehabilitation is a feasible option that includes high levels of engagement and patient satisfaction for veterans with CHD, according to a study published in the American Journal of Cardiology.

“Our findings suggest that a smartphone-enabled, home-based [cardiac rehabilitation] intervention may be an acceptable alternative for veterans who cannot enroll in center-based [cardiac rehabilitation],” Arash Harzand, MD, of the division of cardiology at Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, and colleagues wrote. “This intervention provides incremental evidence among a backdrop of previous studies evaluating smartphones in the delivery of remote [cardiac rehabilitation].”

To investigate the effectiveness of a smartphone-enabled, home-based cardiac rehabilitation program, researchers conducted a prospective, single-arm, nonrandomized feasibility study of 18 veterans who had a diagnosis of CHD and were referred to outpatient cardiac rehabilitation at the Atlanta VA Medical Center from May to December 2016 (mean age, 65 years; all men).

Thirteen veterans completed the 12-week cardiac rehabilitation program, which included a smartphone app that provided participants with daily reminders to exercise, log vitals and review educational materials. Personalized exercise prescriptions were given based on a target range for heart rate. In addition, patients were remotely monitored by a coach through an online dashboard and telephone appointments.

The primary endpoint was to evaluate the feasibility, defined as how active and engaged participants were with the program, and the acceptability, determined by the degree of patient satisfaction with the program as measured by a survey, of the smartphone-enabled cardiac rehabilitation. Secondary and exploratory outcomes included BP and functional capacity.

Based on the app log, researchers found that participants completed a mean of 3.5 exercise sessions (standard deviation, 1.4) and 150 exercise minutes (standard deviation, 86) per week.

The survey revealed that 84% of participants were satisfied overall with the program.

Additionally, researchers found that mean functional capacity improved by 1 metabolic equivalents (from 5.3 to 6.3; 95% CI, 0.3-1.7; P = .008) and that mean systolic BP at rest improved by 9.6 mm Hg (95% CI, –19 to –0.7; P = .049).

“Smartphone-enabled, home-based [cardiac rehabilitation] is feasible and acceptable among low or moderate risk, middle-aged and elderly veterans with CHD, and the preliminary results presented here are consistent with prior studies on home-based [cardiac rehabilitation],” the researchers wrote. “Although center-based programs are the standard of care, mobile technology-enabled [cardiac rehabilitation] may represent a viable option when cost of attendance and geographic distance prohibit access to traditional [cardiac rehabilitation] programs.” – by Melissa J. Webb

Disclosures: Harzand reports financial ties with Moving Analytics. The other authors report no relevant financial disclosures.

Smartphone-enabled, home-based cardiac rehabilitation is a feasible option that includes high levels of engagement and patient satisfaction for veterans with CHD, according to a study published in the American Journal of Cardiology.

“Our findings suggest that a smartphone-enabled, home-based [cardiac rehabilitation] intervention may be an acceptable alternative for veterans who cannot enroll in center-based [cardiac rehabilitation],” Arash Harzand, MD, of the division of cardiology at Emory University School of Medicine and the Atlanta Veterans Affairs Medical Center, and colleagues wrote. “This intervention provides incremental evidence among a backdrop of previous studies evaluating smartphones in the delivery of remote [cardiac rehabilitation].”

To investigate the effectiveness of a smartphone-enabled, home-based cardiac rehabilitation program, researchers conducted a prospective, single-arm, nonrandomized feasibility study of 18 veterans who had a diagnosis of CHD and were referred to outpatient cardiac rehabilitation at the Atlanta VA Medical Center from May to December 2016 (mean age, 65 years; all men).

Thirteen veterans completed the 12-week cardiac rehabilitation program, which included a smartphone app that provided participants with daily reminders to exercise, log vitals and review educational materials. Personalized exercise prescriptions were given based on a target range for heart rate. In addition, patients were remotely monitored by a coach through an online dashboard and telephone appointments.

The primary endpoint was to evaluate the feasibility, defined as how active and engaged participants were with the program, and the acceptability, determined by the degree of patient satisfaction with the program as measured by a survey, of the smartphone-enabled cardiac rehabilitation. Secondary and exploratory outcomes included BP and functional capacity.

Based on the app log, researchers found that participants completed a mean of 3.5 exercise sessions (standard deviation, 1.4) and 150 exercise minutes (standard deviation, 86) per week.

The survey revealed that 84% of participants were satisfied overall with the program.

Additionally, researchers found that mean functional capacity improved by 1 metabolic equivalents (from 5.3 to 6.3; 95% CI, 0.3-1.7; P = .008) and that mean systolic BP at rest improved by 9.6 mm Hg (95% CI, –19 to –0.7; P = .049).

“Smartphone-enabled, home-based [cardiac rehabilitation] is feasible and acceptable among low or moderate risk, middle-aged and elderly veterans with CHD, and the preliminary results presented here are consistent with prior studies on home-based [cardiac rehabilitation],” the researchers wrote. “Although center-based programs are the standard of care, mobile technology-enabled [cardiac rehabilitation] may represent a viable option when cost of attendance and geographic distance prohibit access to traditional [cardiac rehabilitation] programs.” – by Melissa J. Webb

Disclosures: Harzand reports financial ties with Moving Analytics. The other authors report no relevant financial disclosures.