Using Mobile Technology for Cardiac Rehabilitation: A Review and Framework for Development and Evaluation

Beatty, Alexis L.; Fukuoka, Yoshimi; Whooley, Mary A.

doi:10.1161/jaha.113.000568

Cited by 176 publications

(179 citation statements)

References 51 publications

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“…A recent randomized controlled trial demonstrated that patients using smartphone-based CR had significant higher CR participation (80% vs. 62%), adherence (94% vs. 68%) and completion (80% vs. 47%) compared to patients in traditional hospitalbased CR (p<0.05) [71]. Importantly, due to the wide dissemination of mobile technology in particular, including in LMICs, these models hold the potential to dramatically improve CR participation and adherence [71,72]. Health policy makers should strive to facilitate implementation of flexible alternative CR models, through payment to healthcare providers and population-based promotion of these models.…”

Section: Discussionmentioning

confidence: 99%

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

Turk-Adawi

Grace

2015

Heart, Lung and Circulation

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Background-Cardiovascular disease is a leading cause of morbidity worldwide. Cardiac rehabilitation (CR) is a comprehensive secondary prevention approach, with established benefits in reducing morbidity in high-income countries (HICs). The objectives of this review were to summarize what is known about the benefits of CR, including consideration of cost-effectiveness, in addition to rates of CR participation and adherence in high-, as well as low-and middle-income countries (LMICs).

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Section: Discussionmentioning

confidence: 99%

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

Turk-Adawi

Grace

2015

Heart, Lung and Circulation

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“…37,38,130 Health-focused platforms continue to emerge and evidence demonstrating the meaningful impact of technology-based healthy lifestyle interventions is continually growing. [131][132][133][134] There is particular value potential in utilizing the smartphone platform for continual engagement centered on preventive medicine and healthy lifestyle messaging and interventions. 135 Moreover, the use of well-designed technologic platforms has the potential to create individually tailored Understanding systems as complex as the human body has to involve interactive collaboration between specialists from different fields.…”

Section: Leveraging Technologymentioning

confidence: 99%

The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan

Sagner

McNeil

Puska

et al. 2017

Progress in Cardiovascular Diseases

201

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Chronic diseases (i.e., Noncommunicable Diseases), mainly cardiovascular disease, cancer, respiratory diseases and type-2-diabetes, are now the leading cause of death, disability and diminished quality of life on the planet. Moreover, these diseases are also a major financial burden worldwide, significantly impacting the economy of many countries. Healthcare systems and medicine have progressively improved upon the ability to address infectious diseases and react to adverse health events through both surgical interventions and pharmacology; we have become efficient in delivering reactive care (i.e., initiating interventions once an individual is on the verge of or has actually suffered a negative health event). However, with slowly progressing and often 'silent' chronic diseases now being the main cause of illness, healthcare and medicine must evolve into a proactive system, moving away from a merely reactive approach to care. Minimal interactions among the specialists and limited information to the general practitioner and to the individual receiving care lead to a fragmented health approach, non-concerted prescriptions, a scattered follow-up and a suboptimal cost-effectiveness ratio. A new approach in medicine that is predictive, preventive, personalized and participatory, which we label here as "P4" holds great promise to reduce the burden of chronic diseases by harnessing technology and an increasingly better understanding of environment-biology interactions, evidence-based interventions and the underlying mechanisms of chronic diseases. In this concept paper, we propose a 'P4 Health Continuum' model as a framework to promote and facilitate multi-stakeholder collaboration with an orchestrated common language and an integrated care model to increase the healthspan.

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“…146 Mobile CR models are emerging in high-income countries with promising results. 141,147 While there are yet no data from LMICs, one study is under way in Jordan. 147,148 Given the penetrance of mobile technology in many LMICs, these models have significant potential to increase delivery of CR.…”

Section: Alternative Models Of Cr Delivery To Increase Reachmentioning

confidence: 99%

Global availability of cardiac rehabilitation

2014

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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.

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Using Mobile Technology for Cardiac Rehabilitation: A Review and Framework for Development and Evaluation

Cited by 176 publications

References 51 publications

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

Narrative Review Comparing the Benefits of and Participation in Cardiac Rehabilitation in High-, Middle- and Low-Income Countries

The P4 Health Spectrum – A Predictive, Preventive, Personalized and Participatory Continuum for Promoting Healthspan

Global availability of cardiac rehabilitation

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