Mobile health technology to improve uptake of cardiac rehab

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Cardiac rehabilitation is a programme of structured, supervised exercise that is prescribed to people with coronary heart disease (CHD) when they are discharged from hospital. It involves patients attending 1-2 sessions a week at a local hospital or community centre. The benefits of this programme are significant; it improves quality of life, reduces readmission to hospital and the risk of dying from cardiovascular disease. Despite these clear benefits, the uptake of cardiac rehabilitation is low, with only around half of those who are prescribed it attending their sessions. In many cases, there is also a significant delay between discharge from hospital and starting cardiac rehabilitation, which may well be contributing to limited uptake.

This project, led by Professor Helen Jones, developed a mobile health (mhealth) programme called MOTIVATECR+ to help bridge the gap between discharge from hospital and formal rehabilitation. The programme was made up of a home-based walking plan, alongside advice and feedback from exercise professionals; all tracked using a smart watch and app. In total, 63 people were enrolled into the study, and they were asked to measure their blood pressure, weight and cholesterol throughout the course of the programme. The results from the study showed that the people who had gone through MOTIVATECR+ were 6 times more likely to attend cardiac rehabilitation than those who had not done the programme.

They were also more likely to have higher levels of physical activity outside of the programme, with participants reporting that the ability to track their exercise levels and the support from professionals was motivating and built confidence. A major goal of cardiac rehab and this programme is to help people make long term sustainable changes to their behaviour, something that was highlighted by this study:

“I’d say to anyone, if you’re offered it, take it. There’s no bad thing considering what each individual’s been through, whatever their circumstances, it doesn’t hurt. It can only do good, you know. Let’s be honest, if my lifestyle and habits hadn’t been terrible over the years…now they’re the healthiest I’ve been…I’ve seen the gym more in the last three months than I ever have in the rest of my life, you know?” (MCR052).

This study was a feasibility study, which meant, alongside exploring the effectiveness of the programme, the team were establishing whether it is possible to run a full-scale clinical trial to test MOTIVATECR+. They found that the programme is indeed feasible to implement, and so the next stage of this work will be to run a large clinical trial. If this trial confirms the positive results found in this study, MOTIVATECR+ could have the potential to increase the uptake of cardiac rehabilitation. Greater attendance of cardiac rehabilitation, alongside generally increased physical activity, will improve quality of life for people after a heart attack, as well as reducing the chance of repeat heart attacks and increasing long-term survival.