Exploring patient experiences of participating in digital cardiac rehabilitation: A qualitative study

Kenny, Eanna; Byrne, Molly; McEvoy, John W.; Connolly, Susan; McSharry, Jenny

doi:10.1111/bjhp.12692

Cited by 6 publications

References 38 publications

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Advancing translational research in digital cardiac rehabilitation: The preparation phase of the Multiphase Optimization Strategy

Kenny,

McEvoy,

McSharry

et al. 2024

Translational Behavioral Medicine

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While digital cardiac rehabilitation (CR) is an effective alternative to center-based CR, its components and mechanisms of change remain poorly understood. The Multiphase Optimization Strategy (MOST) provides a framework that allows the effects of individual components of complex interventions to be studied. There is limited guidance within MOST on how to develop a conceptual model. This article describes the development of a conceptual model of digital CR. The conceptual model was developed based on several strands of evidence: (i) a systematic review of 25 randomized controlled trials to identify the behavior change techniques in digital CR interventions, (ii) a qualitative study of patients’ (n = 11) perceptions of the mechanisms of digital CR, and (iii) a review of international guidelines. Tools and frameworks from behavioral science, including the Behaviour Change Wheel, Capability, Opportunity, Motivation and Behavior model, and Theoretical Domains Framework were used to integrate the findings. An initial conceptual model of digital CR was developed and then refined through discussion. The conceptual model outlines the causal process through which digital CR can enhance outcomes for patients with cardiovascular disease. The model illustrates the key intervention components (e.g. goal setting and self-monitoring, education, exercise training), targeted outcomes (e.g. physical activity, healthy eating, medication adherence), and theorized mediating variables (e.g. knowledge, beliefs about capability). The article provides an example of how behavioral science frameworks and tools can inform the preparation phase of MOST. The developed conceptual model of digital CR will inform guide decision-making in a future optimization trial.

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Advancing translational research in digital cardiac rehabilitation: The preparation phase of the Multiphase Optimization Strategy

Kenny,

McEvoy,

McSharry

et al. 2024

Translational Behavioral Medicine

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Remote Exercise Engagement Among Individuals With Cardiovascular Disease

Bomtempo,

Main,

Ghisi

2024

Journal of Cardiopulmonary Rehabilitation and Prevention

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Purpose: To systematically review the literature regarding barriers and facilitators to remote exercise among individuals with cardiovascular diseases (CVD). Review Methods: Six databases were searched (inception—December 2023). Studies including barriers and facilitators for remote exercise reported by individuals living with CVD were considered. Quality was rated using the Mixed Methods Assessment Tool (MMAT). Results were synthesized following a thematic analysis approach. Characteristics of interventions were reported using the Template for Intervention Description and Replication (TIDieR). Summary: From an initial pool of 8543 records, 18 studies met the inclusion criteria. Among these, 13 were qualitative studies, with individual interviews being the most frequent data extraction method. Nine studies received 5/5 MMAT scores (ie, high quality). Twelve studies reported remote exercise interventions, mostly delivered within cardiac rehabilitation, by physiotherapists, nurses, and dietitians, predominantly via telephone calls or videoconferences, with only one study incorporating text messages. Five key themes influencing remote exercise interventions were identified: technology (encompassing access and literacy, self-monitoring/motivation, and security concerns), individual health considerations (health/personal aspects and coronavirus disease-2019), social factors (support from health care team and family/social support), environment (facilities), and logistical factors (time and displacement). Several themes served as both facilitators and barriers. Key insights for remote exercise interventions included mobile accessibility, interactive chat sessions, minimal click interactions, short sessions, personalized feedback, and flexible timing. Results emphasize the importance of promoting social interaction and support between participants and health care teams to mitigate barriers and enhance facilitators in remote exercise interventions for individuals with CVD.

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Exploring the feasibility, acceptability, and safety of a real-time cardiac telerehabilitation and tele coaching programme using wearable devices in people with a recent myocardial infarction

Mitropoulos,

Anifanti,

Koukouvou

et al. 2024

BMC Sports Sci Med Rehabil

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Background Cardiac rehabilitation (CR) constitutes the recommended nonpharmacological approach for cardiac patients with cardiovascular disease such as people following a recent (i.e., < 4 week) myocardial infarction (MI). Recent evidence suggests that cardiac telerehabilitation may be as effective as traditional (i.e., in person) CR in people following a recent MI. Nevertheless, the feasibility, acceptability, and safety of such an exercise programme has yet to be examined. Methods Forty-four (11 women, 33 men) people following a recent MI were randomly allocated into two groups (online home-based and gym-based groups). The groups underwent a 24-week CR programme thrice per week. All patients performed the baseline, and 24 weeks follow up measurements where feasibility, acceptability, and safety were assessed. Results Eligibility and recruitment rates were found to be 61.5% and 42%, respectively. Compliance to the thrice weekly, 24-week exercise programme for the online- and gym-based groups were 91.6% and 90.9%, respectively. There were no dropouts during the exercise programmes, however four participants, two from each group, were lost to follow up at 6 months. The average percentage of peak HR (% HR peak ) for the online group was 66.6% ± 4.5 and for the gym-based group was 67.2% ± 5. The average RPE and affect during exercise was for both groups 12 ± 1 (“somewhat hard”) and 3 ± 1 (“good”), respectively. During the 6-month exercise intervention period for both groups, the exercise-induced symptoms were minimal to none. The user suitability evaluation questionnaire revealed that the online real time telerehabilitation and tele coaching programme was enjoyable (4.85 ± 0.37) and did not induce general discomfort (1.20 ± 0.41). Conclusion Our cardiac telerehabilitation programme seems to be feasible, acceptable, safe, and enjoyable for people with a recent MI. Our participants had an overall positive experience and acceptability of the cardiac telerehabilitation and tele coaching using wearable devices. Trial registration ClinicalTrial.gov, ID NCT06071273, 10/02/2023, retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s13102-024-00992-5.

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Exploring patient experiences of participating in digital cardiac rehabilitation: A qualitative study

Cited by 6 publications

References 38 publications

Advancing translational research in digital cardiac rehabilitation: The preparation phase of the Multiphase Optimization Strategy

Advancing translational research in digital cardiac rehabilitation: The preparation phase of the Multiphase Optimization Strategy

Remote Exercise Engagement Among Individuals With Cardiovascular Disease

Exploring the feasibility, acceptability, and safety of a real-time cardiac telerehabilitation and tele coaching programme using wearable devices in people with a recent myocardial infarction

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