Digital Health Interventions for Cardiac Rehabilitation: Systematic Literature Review

Wongvibulsin, Shannon; Habeos, Evagelia E; Huynh, Pauline P.; Xun, Helen; Shan, Rongzi; Rodriguez, Kori A. Porosnicu; Wang, Jane; Gandapur, Yousuf K; Osuji, Ngozi; Shah, Lochan M.; Spaulding, Erin M; Hung, George; Knowles, Kellen; Yang, William; Marvel, Francoise A; Levin, Eleanor; Maron, David J.; Gordon, Neil F.; Martin, Seth S.

doi:10.2196/18773

Cited by 108 publications

(129 citation statements)

References 50 publications

(82 reference statements)

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“…Developing new methods to increase attendance at exCR is deemed paramount[ 5 ]. Such methods could include telehealth, remote monitoring, or a hybrid approach, to increase accessibility and participation[ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to participating in cardiac rehabilitation and physical activity: A cross-sectional survey

Fraser¹,

Leslie²,

Gorely³

et al. 2022

WJC

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BACKGROUND Cardiovascular diseases (CVD) have been shown to be the greatest cause of death worldwide and rates continue to increase. It is recommended that CVD patients attend cardiac rehabilitation (CR) following a cardiac event to reduce mortality, improve recovery and positively influence behaviour around CVD risk factors. Despite the recognised benefits and international recommendations for exercise-based CR, uptake and attendance remain suboptimal. A greater understanding of CR barriers and facilitators is required, not least to inform service development. Through understanding current cardiac patients’ attitudes and opinions around CR and physical activity (PA) could inform patient-led improvements. Moreover, through understanding aspects of CR and PA that participants like/dislike could provide healthcare providers and policy makers with information around what elements to target in the future. AIM To investigate participants’ attitudes and opinions around CR and PA. METHODS This study employed a cross-sectional survey design on 567 cardiac patients. Cardiac patients who were referred for standard CR classes at a hospital in the Scottish Highlands, from May 2016 to May 2017 were sampled. As part of a larger survey, the current study analysed the free-text responses to 5 open-ended questions included within the wider survey. Questions were related to the participants’ experience of CR, reasons for non-attendance, ideas to increase attendance and their opinions on PA. Qualitative data were analysed using a 6-step, reflexive thematic analysis. RESULTS Two main topic areas were explored: “Cardiac rehabilitation experience” and “physical activity”. Self-efficacy was increased as a result of attending CR due to exercising with similar individuals and the safe environment offered. Barriers ranged from age and health to distance and starting times of the classes which increased travel time and costs. Moreover, responses demonstrated a lack of information and communication around the classes. Respondents highlighted that the provision of more classes and classes being held out with working hours, in addition to a greater variety would increase attendance. In terms of PA, respondents viewed this as different to the CR experience. Responses demonstrated increased freedom when conducting PA with regards to the location, time and type of exercise conducted. CONCLUSION Changes to the structure of CR may prove important in creating long term behaviour change after completing the rehabilitation programme.

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Section: Introductionmentioning

confidence: 99%

Barriers and facilitators to participating in cardiac rehabilitation and physical activity: A cross-sectional survey

Fraser¹,

Leslie²,

Gorely³

et al. 2022

WJC

View full text Add to dashboard Cite

show abstract

“…Databases were searched for literature published from January 1990–June 2021. This search date was selected because it was unlikely that connected technologies would be reported on prior to this date, and this timeframe was used by Wongvibulsin et al (2021) [ 18 ], who investigated digital health interventions for CR. Articles had to be in or translatable into English.…”

Section: Methodsmentioning

confidence: 99%

“…Technological advances have allowed the development of CR conducted at the patient’s home, to increase accessibility [ 17 ]. Previous reviews have been conducted into the effectiveness of technology within rehabilitation settings [ 18 , 19 ], though there has been little consideration of rural patients. Understanding what effect technologies can have for rural residents living with CVD is important due to the range of barriers associated with physical activity and health care accessibility.…”

Section: Introductionmentioning

confidence: 99%

“…In home settings, smartphone-based interventions have been shown to improve attendance and completion of CR programmes [ 21 ]. Another form of technology frequently employed within health care settings are ‘digital health interventions’, which is an overarching term used by Wongvibulsin et al (2021) [ 18 ] to describe ‘telemedicine, telehealth and eHealth.’ Such methods allow patients to communicate with healthcare professionals through mediums such as email, audio, or video [ 22 ]. Telehealth also allows the delivery of online exercise programmes at distance and Rawstorn et al (2016) [ 23 ] found CR telehealth interventions to be ‘at-least’ as effective in improving CVD risk factors and functional capacity in comparison to centre-based CR.…”

Section: Introductionmentioning

confidence: 99%

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Does Connected Health Technology Improve Health-Related Outcomes in Rural Cardiac Populations? Systematic Review Narrative Synthesis

Fraser

Gorely

O’Malley

et al. 2022

IJERPH

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Individuals living in rural areas are more likely to experience cardiovascular diseases (CVD) and have increased barriers to regular physical activity in comparison to those in urban areas. This systematic review aimed to understand the types and effects of home-based connected health technologies, used by individuals living in rural areas with CVD. The inclusion criteria included technology deployed at the participant’s home and could be an mHealth (smart device, fitness tracker or app) or telehealth intervention. Nine electronic databases were searched across the date range January 1990–June 2021. A total of 207 full texts were screened, of which five studies were included, consisting of 603 participants. Of the five studies, four used a telehealth intervention and one used a form of wearable technology. All interventions which used a form of telehealth found a reduction in overall healthcare utilisation, and one study found improvements in CVD risk factors. Acceptability of the technologies was mixed, in some studies barriers and challenges were cited. Based on the findings, there is great potential for implementing connected health technologies, but due to the low number of studies which met the inclusion criteria, further research is required within rural areas for those living with cardiovascular disease.

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“…To address the inconsistent views about the patients' exercise adherence in cardiac telerehabilitation, further research is necessary. Therefore, more comprehensive tracking and interpreting are necessary for long-term follow-up of cardiac telerehabilitation [73]. As the special period with the coronavirus disease will probably continue for a long period [74], it is increasingly important to explore AI more in the longitudinal follow-up of cardiac telerehabilitation.…”

Section: Tracking and Interpreting Cardiac Functional Capacitymentioning

confidence: 99%

Mobilizing artificial intelligence to cardiac telerehabilitation

Jin¹,

Zhang²,

Ke³

et al. 2022

Rev. Cardiovasc. Med.

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Cardiac telerehabilitation is a method that uses digital technologies to deliver cardiac rehabilitation from a distance. It has been shown to have benefits to improve patients' disease outcomes and quality of life, and further reduce readmission and adverse cardiac events. The outbreak of the coronavirus pandemic has brought considerable new challenges to cardiac rehabilitation, which foster cardiac telerehabilitation to be broadly applied. This transformation is associated with some difficulties that urgently need some innovations to search for the right path. Artificial intelligence, which has a high level of data mining and interpretation, may provide a potential solution. This review evaluates the current application and limitations of artificial intelligence in cardiac telerehabilitation and offers prospects.

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Digital Health Interventions for Cardiac Rehabilitation: Systematic Literature Review

Cited by 108 publications

References 50 publications

Barriers and facilitators to participating in cardiac rehabilitation and physical activity: A cross-sectional survey

Barriers and facilitators to participating in cardiac rehabilitation and physical activity: A cross-sectional survey

Does Connected Health Technology Improve Health-Related Outcomes in Rural Cardiac Populations? Systematic Review Narrative Synthesis

Mobilizing artificial intelligence to cardiac telerehabilitation

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