Changes in patient activation following cardiac rehabilitation using the Active+me digital healthcare platform during the COVID-19 pandemic: a cohort evaluation

Frith, Gabbi; Carver, Kathryn; Curry, Sarah; Darby, Alan; Sydes, Anna; Symonds, Stephen; Wilson, Katrina; Mcgregor, Gordon; Auton, Kevin; Nichols, Simon

Abstract

Background: Restrictions on face-to-face contact, due to COVID-19, led to a rapid adoption of technology to remotely deliver cardiac rehabilitation (CR). Some technologies, including Active + me, were used without knowing their benefits. We assessed changes in patient activation measure (PAM) in patients participating in routine CR, using Active + me. We also investigated changes in PAM among low, moderate, and high risk patients, changes in cardiovas-cular risk factors, and explored patient and healthcare professional experiences of using Active + me. Methods: Patients received standard CR education and an exercise prescription. Active + me was used to monitor patient health, progress towards goals, and provide additional lifestyle support. Patients accessed Active + me through a smart-device application which synchronised to telemetry enabled scales, blood pressure monitors, pulse oxime-ter, and activity trackers. Changes in PAM score following CR were calculated. Subgroup analysis was conducted on patients at high, moderate, and low risk of exercise induced cardiovascular events. Qualitative interviews explored the acceptability of Active + me. Results: Forty-six patients were recruited (Age: 60.4 ± 10.9 years; BMI: 27.9 ± 5.0 kg. m 2 ; 78.3% male). PAM scores increased from 65.5 (range: 51.0 to 100.0) to 70.2 (range: 40.7 to 100.0; P = 0.039). PAM scores of high risk patients increased from 61.9 (range: 53.0 to 91.0) to 75.0 (range: 58.1 to 100.0; P = 0.044). The PAM scores of moderate and low risk patients did not change. Resting systolic blood pressure decreased from 125 mmHg (95% CI: 120 to 130 mmHg) to 119 mmHg (95% CI: 115 to 122 mmHg; P = 0.023) and waist circumference measurements decreased from 92.8 cm (95% CI: 82.6 to 102.9 cm) to 85.3 cm (95% CI 79.1 to 96.2 cm; P = 0.026). Self-reported physical activity levels increased from 1557.5 MET-minutes (range: 245.0 to 5355.0 MET-minutes) to 3363.2 MET-minutes (range: 105.0 to 12,360.0 MET-minutes; P < 0.001). Active + me was acceptable to patients and healthcare professionals.

Citation

Frith, G., Carver, K., Curry, S., Darby, A., Sydes, A., Symonds, S., Wilson, K., Mcgregor, G., Auton, K., & Nichols, S. (2021). Changes in patient activation following cardiac rehabilitation using the Active+me digital healthcare platform during the COVID-19 pandemic: a cohort evaluation. BMC Health Services Research, 21(1), Article 1363. https://doi.org/10.1186/s12913-021-07363-7

• Journal Article Type: Article
• Acceptance Date: Nov 24, 2021
• Online Publication Date: Dec 24, 2021
• Publication Date: 2021-12
• Deposit Date: Oct 14, 2024
• Publicly Available Date: Oct 14, 2024
• Journal: BMC Health Services Research
• Electronic ISSN: 1472-6963
• Publisher: BMC
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 1
• Article Number: 1363
• DOI: https://doi.org/10.1186/s12913-021-07363-7
• Keywords: Cardiac rehabilitation, Patient activation, Self-efficacy, Tele-health, COVID-19
• Additional Information: Ethical approval for the evaluation was obtained from Sheffield Hallam University Ethics Committee (ER26525336). The evaluation was also approved by Addenbrooke’s Hospital (ID 3224; Ref no. PRN9224). Study procedures conform to the 1975 Declaration of Helsinki and is subsequent revisions. Informed consent was obtained prior to enrolling patients on to the evaluation.; : AD and AS are employed by the healthcare organisation responsible for routinely delivering cardiac rehabilitation at Addenbrooke’s Hospital. KC is the President Elect for the British Association for Cardiovascular Rehabilitation. KA is the CEO of Aseptika Ltd. SN is a member of the British Association for Cardiovascular Rehabilitation Council. SN has also received research funding from AstraZeneca to investigate factors influencing participation and adherence to cardiac rehabilitation.