JMIR Publications

ABSTRACT

Background:

Long-term maintenance of preventive activities is fundamental for achieving improved outcomes of cardiac rehabilitation (CR). Despite this, it is shown to be a major challenge for many patients to follow recommendations and thereby adhere to a heart-healthy lifestyle. Smartphone applications (apps) have been emphasized as potential tools to promote preventive activities after attendance in a CR program. Before commencing a trial to assess the potential effect of using an app to promote long-term adherence to preventive activities after attendance in CR, a study to assess if it is feasible to use an app is warranted.

Objective:

To assess if it is feasible to use a smartphone app for promoting and monitoring patients´ adherence to a heart-healthy lifestyle after CR

Methods:

Experimental, pre-post single arm trial, lasting for 12 weeks. All patients received access to an app aimed to guide individuals to change or maintain a heart-healthy lifestyle. During the study period, patients received weekly, individualized monitoring through the app, based on their own goals. Feasibility outcomes assessed were recruitment rate, adherence to the app, resource requirements and efficacy regarding capability to detect a change in quality of life (QoL), health status and perceived goal achievement as well as evaluating ceiling and floor effect in these outcomes. Criteria for success were preset to be able to evaluate whether the app was feasible to use in a potential future RCT.

Results:

In total, 71% of the patients that completed CR were eligible for a potential RCT as well as for the present study. All 14 patients included in the study used the app to promote preventive activities throughout the study. Satisfaction with the technology was high and the patients found the technology based follow-up intervention both useful and motivational. Ceiling effect was present in more than 20% of the patients in several domains of the questionnaires evaluating quality of life (SF-36 and COOP/WONCA) and health status (EQ-5D). Overall self-rated health status (EQ VAS) and perceived goal achievement were found to be outcomes able to detect a change.

Conclusions:

Individual follow-up through an app after attendance in CR is feasible. All patients used the app for preventive activities and found the app both useful and motivating. Several points of guidance from the patients in the current study have been taken along and contributed to the final design of the RCT now in the field.