Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: May 6, 2024
Date Accepted: Dec 18, 2024
Effects of individualized follow-up with an app post-cardiac rehabilitation: Five-years follow-up of a randomized controlled trial
ABSTRACT
Background:
Adherence to healthy behaviours, initiated and/or adapted in cardiac rehabilitation (CR) is challenging and few patients meet the guideline standards for secondary prevention. In a former study, we demonstrated increased adherence to healthy behaviour one-year post-CR when using an app for individualized follow-up. It is still uncertain whether these effects persist when the follow-up cease. The aim of this study was to examine the long-term effects, four years post-intervention of the individualized follow-up with an app.
Objective:
The aim of this study was to examine the long-term effects, four years post-intervention of the individualized follow-up with an app.
Methods:
A single-blinded multicentre randomized controlled trial was designed. The intervention group (IG) received individualized follow-up with an app for one year, while the control group (CG) received usual care. Primary outcome was difference in peak oxygen uptake (VO2peak). Secondary outcomes included exercise performance, bodyweight, blood pressure, lipid profile, exercise habits, health related quality of life, health status, cardiac events, and physical activity. Linear mixed models for repeated measurements were used to analyse for differences between groups. All tests were two-sided, and p-values ≤0.05 were considered as statistically significant.
Results:
At five-year follow-up, 101 out of the initial 113 randomized were reassessed. Intention-to-treat analyses using a mixed model for repeated measurements, showed a statistically significant difference in exercise habits in favour of the IG. Statistically significant differences were also found in triglycerides and walking, but in favour of the CG. No statistically significant differences were observed between the groups for other evaluated outcomes.
Conclusions:
Most of the benefits derived from the app-based follow-up ceased by the five-years follow-up. Although the IG reported statistically significant higher levels of exercise, this was not translated into better VO2peak or exercise performance. Our study underlines the need of follow-up from healthcare providers to increase the chance to succeed with adherence to healthy behaviour post-CR. Clinical Trial: ClinicalTrials.gov: NCT05697120
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