Digital health intervention during cardiac rehabilitation

A randomized controlled trial

R. Jay Widmer, Thomas G. Allison, Ryan Lennon, Francisco Lopez-Jimenez, Lilach O Lerman, Amir Lerman

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Digital health interventions (DHI) have been shown to improve intermediates of cardiovascular health, but their impact on cardiovascular (CV) outcomes has not been fully explored. The aim of this study was to determine whether DHI administered during cardiac rehabilitation (CR) would reduce CV-related emergency department (ED) visits and rehospitalizations in patients after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods We randomized patients undergoing CR following ACS and PCI to standard CR (n = 40) or CR + DHI (n = 40) for 3 months with 3 patients withdrawing from CR prior to initiation in the treatment arm and 6 in the control group. The DHI incorporated an online and smartphone-based CR platform asking the patients to report of dietary and exercise habits throughout CR as well as educational information toward patients' healthy lifestyles. We obtained data regarding ED visits and rehospitalizations at 180 days, as well as other metrics of secondary CV prevention at baseline and 90 days. Results Baseline demographics were similar between the groups. The DHI + CR group had improved weight loss compared to the control group (−5.1 ± 6.5 kg vs. −0.8 ± 3.8 kg, respectively, P = .02). Those in the DHI + CR group also showed a non-significant reduction in CV-related rehospitalizations plus ED visits compared to the control group at 180 days (8.1% vs 26.6%; RR 0.30, 95% CI 0.08-1.10, P = .054). Conclusions The current study demonstrated that complementary DHI significantly improves weight loss, and might offer a method to reduce CV-related ED visits plus rehospitalizations in patients after ACS undergoing CR. The study suggests a role for DHI as an adjunct to CR to improve secondary prevention of CV disease. Trial registration This trial is registered at clinicaltrials.gov (NCT01883050).

Original languageEnglish (US)
Pages (from-to)65-72
Number of pages8
JournalAmerican Heart Journal
Volume188
DOIs
StatePublished - Jun 1 2017

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Randomized Controlled Trials
Health
Hospital Emergency Service
Acute Coronary Syndrome
Percutaneous Coronary Intervention
Secondary Prevention
Control Groups
Weight Loss
Cardiac Rehabilitation
Feeding Behavior
Cardiovascular Diseases
Demography
Exercise

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Digital health intervention during cardiac rehabilitation : A randomized controlled trial. / Widmer, R. Jay; Allison, Thomas G.; Lennon, Ryan; Lopez-Jimenez, Francisco; Lerman, Lilach O; Lerman, Amir.

In: American Heart Journal, Vol. 188, 01.06.2017, p. 65-72.

Research output: Contribution to journalArticle

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abstract = "Background Digital health interventions (DHI) have been shown to improve intermediates of cardiovascular health, but their impact on cardiovascular (CV) outcomes has not been fully explored. The aim of this study was to determine whether DHI administered during cardiac rehabilitation (CR) would reduce CV-related emergency department (ED) visits and rehospitalizations in patients after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods We randomized patients undergoing CR following ACS and PCI to standard CR (n = 40) or CR + DHI (n = 40) for 3 months with 3 patients withdrawing from CR prior to initiation in the treatment arm and 6 in the control group. The DHI incorporated an online and smartphone-based CR platform asking the patients to report of dietary and exercise habits throughout CR as well as educational information toward patients' healthy lifestyles. We obtained data regarding ED visits and rehospitalizations at 180 days, as well as other metrics of secondary CV prevention at baseline and 90 days. Results Baseline demographics were similar between the groups. The DHI + CR group had improved weight loss compared to the control group (−5.1 ± 6.5 kg vs. −0.8 ± 3.8 kg, respectively, P = .02). Those in the DHI + CR group also showed a non-significant reduction in CV-related rehospitalizations plus ED visits compared to the control group at 180 days (8.1{\%} vs 26.6{\%}; RR 0.30, 95{\%} CI 0.08-1.10, P = .054). Conclusions The current study demonstrated that complementary DHI significantly improves weight loss, and might offer a method to reduce CV-related ED visits plus rehospitalizations in patients after ACS undergoing CR. The study suggests a role for DHI as an adjunct to CR to improve secondary prevention of CV disease. Trial registration This trial is registered at clinicaltrials.gov (NCT01883050).",
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