Changes in patient activation following cardiac rehabilitation using the Active+me digital healthcare platform during the COVID-19 pandemic: a cohort evaluation.
BMC Health Serv Res
; 21(1): 1363, 2021 Dec 24.
Article
in English
| MEDLINE | ID: covidwho-1632397
ABSTRACT
BACKGROUND:
Restrictions on face-to-face contact, due to COVID-19, led to a rapid adoption of technology to remotely deliver cardiac rehabilitation (CR). Some technologies, including Active+me, were used without knowing their benefits. We assessed changes in patient activation measure (PAM) in patients participating in routine CR, using Active+me. We also investigated changes in PAM among low, moderate, and high risk patients, changes in cardiovascular risk factors, and explored patient and healthcare professional experiences of using Active+me.METHODS:
Patients received standard CR education and an exercise prescription. Active+me was used to monitor patient health, progress towards goals, and provide additional lifestyle support. Patients accessed Active+me through a smart-device application which synchronised to telemetry enabled scales, blood pressure monitors, pulse oximeter, and activity trackers. Changes in PAM score following CR were calculated. Sub-group analysis was conducted on patients at high, moderate, and low risk of exercise induced cardiovascular events. Qualitative interviews explored the acceptability of Active+me.RESULTS:
Forty-six patients were recruited (Age 60.4 ± 10.9 years; BMI 27.9 ± 5.0 kg.m2; 78.3% male). PAM scores increased from 65.5 (range 51.0 to 100.0) to 70.2 (range 40.7 to 100.0; P = 0.039). PAM scores of high risk patients increased from 61.9 (range 53.0 to 91.0) to 75.0 (range 58.1 to 100.0; P = 0.044). The PAM scores of moderate and low risk patients did not change. Resting systolic blood pressure decreased from 125 mmHg (95% CI 120 to 130 mmHg) to 119 mmHg (95% CI 115 to 122 mmHg; P = 0.023) and waist circumference measurements decreased from 92.8 cm (95% CI 82.6 to 102.9 cm) to 85.3 cm (95% CI 79.1 to 96.2 cm; P = 0.026). Self-reported physical activity levels increased from 1557.5 MET-minutes (range 245.0 to 5355.0 MET-minutes) to 3363.2 MET-minutes (range 105.0 to 12,360.0 MET-minutes; P < 0.001). Active+me was acceptable to patients and healthcare professionals.CONCLUSION:
Participation in standard CR, with Active+me, is associated with increased patient skill, knowledge, and confidence to manage their condition. Active+me may be an appropriate platform to support CR delivery when patients cannot be seen face-to-face. TRIAL REGISTRATION As this was not a clinical trial, the study was not registered in a trial registry.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Cardiac Rehabilitation
/
COVID-19
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Qualitative research
/
Randomized controlled trials
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
BMC Health Serv Res
Journal subject:
Health Services Research
Year:
2021
Document Type:
Article
Affiliation country:
S12913-021-07363-7
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