Patient focused Internet-based approaches to cardiovascular rehabilitation – a systematic review

Munro, Julie; Angus, Neil; Leslie, Stephen J

doi:10.1177/1357633x13501763

Cited by 41 publications

(31 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These program models have advantages in terms of cost, time (i.e., no conflict with work schedules, no transportation required, less interference with family obligations), privacy (i.e., no group embarrassment), and in overcoming logistical barriers such as infrastructure and health human resource constraints. Based on our literature review, internet-or web-based models 141,146 have only been tested in high-income countries to date. Because of the variations in the internet-based interventions, it was not possible to compare effectiveness of internet-based with hospital-based CR program 146 ; still, the internet-based interventions had positive effects on health behavior compliance, physical activity, as well as psychosocial and clinical outcomes (i.e., blood pressure, cholesterol, hospital visits.…”

Section: Alternative Models Of Cr Delivery To Increase Reachmentioning

confidence: 99%

“…Based on our literature review, internet-or web-based models 141,146 have only been tested in high-income countries to date. Because of the variations in the internet-based interventions, it was not possible to compare effectiveness of internet-based with hospital-based CR program 146 ; still, the internet-based interventions had positive effects on health behavior compliance, physical activity, as well as psychosocial and clinical outcomes (i.e., blood pressure, cholesterol, hospital visits. 146 Mobile CR models are emerging in high-income countries with promising results.…”

Section: Alternative Models Of Cr Delivery To Increase Reachmentioning

confidence: 99%

See 1 more Smart Citation

Global availability of cardiac rehabilitation

2014

View full text Add to dashboard Cite

The most prevalent non-communicable disease globally, namely cardiovascular disease (CVD), is also the leading cause of mortality, with over 80% of the deaths occurring in low-and middleincome countries. To lessen the impact of CVDs on individuals and societies, a comprehensive approach is needed. Cardiac rehabilitation (CR) involves delivery of structured exercise, education and risk reduction, in a cost-effective manner. Robust evidence demonstrates it reduces mortality up to 25%, improves functional capacity, as well as decreases re-hospitalization. Despite its benefits, and clinical practice guideline recommendations to refer cardiac patients, CR programs are grossly under-used. Worldwide, there is low availability of CR; only 38.8% of countries globally have CR programs. Specifically, 68.0% of high-income and 23% of LMICs (28.2% for middle-and 8.3% for low-income countries) have CR. CR density estimates ranged from 1 program per 0.1-6.4 million inhabitants. CR availability is much lower than that of other evidencebased secondary prevention therapies, such as revascularization and pharmacological therapies. Multi-level strategies to augment CR capacity and availability at national and international levels such as supportive public health policies, systematic referral strategies, and alternative models of delivery are needed.

show abstract

Section: Alternative Models Of Cr Delivery To Increase Reachmentioning

confidence: 99%

Section: Alternative Models Of Cr Delivery To Increase Reachmentioning

confidence: 99%

Global availability of cardiac rehabilitation

2014

View full text Add to dashboard Cite

show abstract

“…21,22,39,40 To our knowledge, only 1 randomized study previously investigated the use of the Internet for cardiac rehabilitation remotely, 23 which comprised online chats between patients and nurses/dietitians, online educational resources, and financial incentives for participation. After 6 months, there was no difference in exercise capacity and the only parameter to improve compared with the control group was weight reduction.…”

Section: Summary Of the Experience Futurementioning

confidence: 99%

“…Despite the enthusiasm for technology supported healthcare services, the evidence to support such use in cardiac rehabilitation is limited to pilot studies. [21][22][23][24] As a result, a recent American Heart Association Presidential Advisory has called for more robust research to test the feasibility and effectiveness of Internet-based CRP. 25 Our goal therefore, was to test the clinical effectiveness of a virtual CRP (vCRP) delivered exclusively using Internet-based technology.…”

mentioning

confidence: 99%

Randomized Trial of a Virtual Cardiac Rehabilitation Program Delivered at a Distance via the Internet

Lear

Singer

Banner

et al. 2014

Circ: Cardiovascular Quality and Outcomes

149

View full text Add to dashboard Cite

With an aging population in many Western countries and increases in risk factors such as obesity, the number of patients with cardiovascular diseases (CVDs) is increasing. 1 These patients are at greater risk of subsequent events, comorbidities, and premature mortality, therefore effective and ongoing management is needed to reduce this risk. Cardiac rehabilitation programs (CRPs) are effective at improving lifestyle behaviors and reducing risk factors in patients with CVD, as well as reducing CVD events and premature mortality, while being cost-effective.2-5 As a result, the American Heart Association, and others, have highlighted participation in CRP as an essential element of secondary prevention in patients with CVD. [6][7][8] Despite the known benefits of CRP, as little as 10% to 30% of eligible patients attend these programs. [9][10][11][12][13] The majority of these programs are limited to hospitals in large urban areas with geographical accessibility as one of the main barriers to attendance.14,15 Lack of access is more pronounced for patients in rural areas that do not have CRP, 16,17 although risk factors such as smoking and obesity are higher in rural populations 18 resulting in a greater rate of hospitalizations than urban populations.19 Home-based CRP have been developed to address the accessibility issue, and a review of these studies found no difference to hospital-based CRP with respect to improvements in CVD risk. 20 However, these programs generally consist of a mix of on-site exercise sessions, clinic or home visits, telephone calls from staff, and diaries, which still require patients to attend some sort of clinic and therefore do not accommodate patients in outlying areas.The proliferation of low-cost communications technology, such as the Internet, has opened up an array of opportunities for patient communication while bridging geographic distance. The Internet holds great promise in improving access to healthcare services as it is ubiquitous, requires little infrastructure and cost, and is readily scalable to large populations. Despite the enthusiasm for technology supported healthcare services, the evidence to support such use in cardiac rehabilitation is limited to pilot studies. [21][22][23][24] As a result, a recent American Heart Association Presidential Advisory has called for more robust research to test the feasibility and effectiveness of Internet-based CRP. 25 Our goal therefore, was to test the clinical effectiveness of a virtual CRP (vCRP) delivered exclusively using Internet-based technology. Local Challenges in ImplementationA common challenge to the implementation of CRP is the cost of their implementation despite having been demonstrated to be cost-effective.5 This challenge also holds true for technology-based solutions. Although several communication technology mediums exist (telephone, video-conferencing, and telemonitoring), we chose to use a web-based program delivered through the Internet as it is (1) commonly available in people's homes, (2) requires less capital exp...

show abstract

“…Recent studies have shown that these modalities are effective for health screening, education and intervention, and can even improve health outcomes. [26][27][28][29] Studies in MS in particular have shown that patients are not only willing to utilise technology to report on their health, but that these methods are successful at obtaining valuable patient-level information. [30][31][32] A recent study evaluated Internet use in 586 MS patients and found that 94 % had Internet access, with approximately one-third seeking MS-specific information.…”

Section: Patient-based Assessmentmentioning

confidence: 99%

A Novel Electronic Application of Patient-reported Outcomes in Multiple Sclerosis – Meeting the Necessary Challenge of Assessing Quality of Life and Outcomes in Daily Clinical Practice

Exell¹,

Thristan²,

Dangond³

et al. 2014

European Neurological Review

View full text Add to dashboard Cite

Multiple sclerosis (MS) has a substantial negative impact on health-related quality of life. Clinical assessments often do not include standardised, routine assessment of MS impact from the patient perspective, and communication between healthcare practitioners (HCPs) and patients can be lacking. Thus, there is a need for patient-reported outcome (PRO) measures to encourage patient-HCP communication, to help inform HCPs of matters important to patients and to aid both patients and HCPs in managing the disease.MSdialog is a web-and mobile-based software application that works with auto-injector devices and electronic autoinjectors, including the RebiSmart ® 2.0 device (a handheld electronic Rebif ® auto-injector with wireless data transmission capabilities, CE marked and available worldwide [excluding the US]) to collect and store real-time, point-of-administration adherence, clinician-reported outcomes and PRO data. MSdialog may provide a practical solution to support patient-proactive engagements and self-management, patient-centred care and participatory decision-making in clinical practice.

show abstract

Patient focused Internet-based approaches to cardiovascular rehabilitation – a systematic review

Cited by 41 publications

References 18 publications

Global availability of cardiac rehabilitation

Global availability of cardiac rehabilitation

Randomized Trial of a Virtual Cardiac Rehabilitation Program Delivered at a Distance via the Internet

A Novel Electronic Application of Patient-reported Outcomes in Multiple Sclerosis – Meeting the Necessary Challenge of Assessing Quality of Life and Outcomes in Daily Clinical Practice

Contact Info

Product

Resources

About