Abstract
Introduction: Cardiac Rehabilitation (CR) for patients with Coronary Heart Disease (CHD) is typically delivered in hospital-based classes and is recommended to help people reduce their risk of further cardiac events. However, many eligible people are not completing the programme. This study aimed to assess the feasibility of delivering a web-based CR intervention for those who decline or drop-out from usual CR.
Intervention: a web-based cardiac rehabilitation programme for 6-months, facilitated with remote support from the CR team.
Methods: Two-centre, randomised controlled feasibility trial. Patients were randomly allocated to either web-based CR or usual care for 6-months. Data was collected to inform the design of a larger study and included: recruitment rates, quality of life (MacNew), exercise capacity (incremental shuttle walk test) and mood (Hospital Anxiety and Depression Scale). Measurement of health utility and resource use was also evaluated for feasibility.
Results: 60 patients were randomised (90% male, mean age 62 ± 9 years, 26% of those eligible). 82% completed all three assessment visits. 78% of the web group had completed the programme at 6-months. Quality of life improved in the web group by a clinically meaningful amount at 6-months (0.5 ± 1.1 units Vs 0.2 ± 0.7 unit: control). Exercise capacity improved in both groups (53 ± 77 metres: web, 86 ± 115 metres in the control) at 6-months. Mood did not change in either group. It was feasible to collect health utility data.
Conclusions: It was feasible to recruit and retention to the end of the study was very good. The web group reported important improvements in quality of life. This intervention has the opportunity to increase access to CR for patients who would otherwise not attend. In turn, this could reduce the risk of future cardiac events. Promising outcomes and recruitment suggest feasibility for a full scale trial.
ISRCTN Trial Registration number: 10726798.
Intervention: a web-based cardiac rehabilitation programme for 6-months, facilitated with remote support from the CR team.
Methods: Two-centre, randomised controlled feasibility trial. Patients were randomly allocated to either web-based CR or usual care for 6-months. Data was collected to inform the design of a larger study and included: recruitment rates, quality of life (MacNew), exercise capacity (incremental shuttle walk test) and mood (Hospital Anxiety and Depression Scale). Measurement of health utility and resource use was also evaluated for feasibility.
Results: 60 patients were randomised (90% male, mean age 62 ± 9 years, 26% of those eligible). 82% completed all three assessment visits. 78% of the web group had completed the programme at 6-months. Quality of life improved in the web group by a clinically meaningful amount at 6-months (0.5 ± 1.1 units Vs 0.2 ± 0.7 unit: control). Exercise capacity improved in both groups (53 ± 77 metres: web, 86 ± 115 metres in the control) at 6-months. Mood did not change in either group. It was feasible to collect health utility data.
Conclusions: It was feasible to recruit and retention to the end of the study was very good. The web group reported important improvements in quality of life. This intervention has the opportunity to increase access to CR for patients who would otherwise not attend. In turn, this could reduce the risk of future cardiac events. Promising outcomes and recruitment suggest feasibility for a full scale trial.
ISRCTN Trial Registration number: 10726798.
| Original language | English |
|---|---|
| Journal | Open Heart |
| DOIs | |
| Publication status | Published - 8 Oct 2018 |