Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial

作者：Marlien Varnfield, Mohan Karunanithi, Chi-Keung Lee, Enone Honeyman, Desre Arnold, Hang Ding, Catherine L. Smith, D. Walters · 发表于：Heart · 年份：2014 · DOI：10.1136/heartjnl-2014-305783 · 被引用次数：561 · 研究领域：Cardiac Health and Mental Health、Stroke Rehabilitation and Recovery、Music Therapy and Health

OBJECTIVE: Cardiac rehabilitation (CR) is pivotal in preventing recurring events of myocardial infarction (MI). This study aims to investigate the effect of a smartphone-based home service delivery (Care Assessment Platform) of CR (CAP-CR) on CR use and health outcomes compared with a traditional, centre-based programme (TCR) in post-MI patients. METHODS: In this unblinded randomised controlled trial, post-MI patients were randomised to TCR (n=60; 55.7±10.4 years) and CAP-CR (n=60; 55.5±9.6 years) for a 6-week CR and 6-month self-maintenance period. CAP-CR, delivered in participants' homes, included health and exercise monitoring, motivational and educational material delivery, and weekly mentoring consultations. CAP-CR uptake, adherence and completion rates were compared with TCR using intention-to-treat analyses. Changes in clinical outcomes (modifiable lifestyle factors, biomedical risk factors and health-related quality of life) across baseline, 6 weeks and 6 months were compared within, and between, groups using linear mixed model regression. RESULTS: CAP-CR had significantly higher uptake (80% vs 62%), adherence (94% vs 68%) and completion (80% vs 47%) rates than TCR (p<0.05). Both groups showed significant improvements in 6-minute walk test from baseline to 6 weeks (TCR: 537±86-584±99 m; CAP-CR: 510±77-570±80 m), which was maintained at 6 months. CAP-CR showed slight weight reduction (89±20-88±21 kg) and also demonstrated significant improvements in emotional state (K1...