Cardiovascular disease (CVD) is the leading cause of death in the world. Comprehensive cardiac rehabilitation (CR) programs have repeatedly been shown to reduce morbidity and mortality while improving symptoms and quality of life for patients living with this chronic disease. While referral rates to CR programs for patients following a coronary event or procedure have slowly begun to increase in recent years, patient participation in these programs has not. Further, adherence and completion of CR programs for those patients enrolled also falls well short of target. There are a number of known barriers to participation in and completion of CR, which contribute substantially the widening gap between CR referral, enrollment, and completion of CR. The objective of this proposal is to determine the effectiveness of a mobile health (mHealth) remote case management platform for increasing CR adherence, improving CVD risk factors, and improving patient- centered outcomes. This prospective, randomized controlled trial of CR using a mHealth remote case management platform compared to conventional center-based CR has been developed through interaction with a number of key stakeholders including patients, clinical CR support staff, scientists, physicians, and healthcare leaders. All non-surgical patients who have experienced a myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, have stable angina, or have heart failure will automatically be referred to CR and be eligible to participate in this trial. We anticipate that patients who utilize the mHealth remote case management platform will have improved clinical outcomes compared to conventional center-based CR, as evidenced by increased adherence to CR programming, improved CVD risk factors, and improved rehospitalizations/mortality.
Comprehensive cardiac rehabilitation (CR) programs have repeatedly demonstrated efficacy in reducing morbidity and mortality while improving symptoms and quality of life for patients living with CVD; unfortunately, enrollment, adherence, and completion of CR programs are particularly low and thus patients are not receiving these known benefits. We aim to determine the effectiveness of delivering patient-centered individualized CR programming through a mobile health (mHealth) remote case management system in an effort to a) increase participation in and adherence to CR programming, b) improve known modifiable CVD risk factors, and c) improve near- and mid-term patient-centered outcomes including re-hospitalizations and mortality. Ultimately, this type of enhanced clinical service will provide patients with additional/alternative strategies to engage with clinical care teams and improve healthcare outcomes.
