JMIR Publications

ABSTRACT

Background:

The transition between hospitalization and outpatient cardiac rehabilitation (CR), which we define as phase 1.5, can be a time of great anxiety and unmet educational needs. Additionally, long wait times to enter CR compound this problem and contribute to the underutilization of CR. Interventions during this transition period could improve care and promote CR enrollment.

Objective:

To investigate the feasibility of introducing a mobile phase 1.5 app designed to maximize patient engagement during the transition period between Phase 1 and Phase 2 CR.

Methods:

We piloted a phase 1.5 app (Chanl Care) in a prospective study to help patients begin their recovery journey immediately after hospital discharge. After a standard inpatient CR visit that included education, motivation, referral, and often appointments; we approached CR eligible patients and offered the mobile health app. The app included daily education modules; logs for tracking exercise, vital signs, and medication use; and an optional chat feature. We assessed app uptake, usability [measured by the system usability score (SUS)], engagement [low, moderate, or high], and outpatient CR enrollment rates.

Results:

Of 35 sequential patients approached, 20 (57%) patients downloaded the app. Patient engagement was modest, with 9 (45%), 4 (20%), and 7 (35%) patients in the low, moderate, and high engagement groups, respectively. Usability scores were high, with an average SUS score of 88 ± 11. Outpatient CR attendance was 75% (15/20) for Chanl Care users, 33% (5/15) among non-users, and 46% (29/63) among control patients who were never approached for the intervention (p = 0.02). Using an intent-to-treat approach, intervention patients were more likely to attend CR, but this was not statistically significant. [OR 1.5 (95% CI 0.68 to 3.6), p = 0.40]

Conclusions:

The Chanl Care Phase 1.5 app appears feasible, may represent a novel method to increase CR enrollment, and should be further tested in randomized trials.