Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov 1;122(9):1471-1476.
doi: 10.1016/j.amjcard.2018.07.028. Epub 2018 Aug 4.

Feasibility of a Smartphone-enabled Cardiac Rehabilitation Program in Male Veterans With Previous Clinical Evidence of Coronary Heart Disease

Arash Harzand  1 , Bradley Witbrodt  2 , Michelle L Davis-Watts  3 , Alaaeddin Alrohaibani  3 , David Goese  2 , Nanette K Wenger  4 , Amit J Shah  5 , Abarmard Maziar Zafari  1
Affiliations

Feasibility of a Smartphone-enabled Cardiac Rehabilitation Program in Male Veterans With Previous Clinical Evidence of Coronary Heart Disease

Arash Harzand et al. Am J Cardiol. .

Abstract

Cardiac rehabilitation (CR) is recommended for patients with coronary heart disease, however, participation among veterans remains poor. Smartphones may facilitate data transfer and communication between patients and providers, among other benefits. We evaluated the feasibility of a smartphone-enabled CR program in a population of veterans. Qualifying veterans were prospectively enrolled in a single-arm, nonrandomized feasibility study of a smartphone-enabled, home-based CR program, featuring an app with daily reminders to exercise, log vitals, and review educational materials. A coach remotely monitored patients through an online dashboard and scheduled telephone visits. Clinical end points were assessed as an exploratory aim. After 21 veterans provided informed consent, 18 were enrolled and successfully completed at least 30days of the program; 13 completed the entire 12-week intervention. Mean (standard deviation) age was 62 (7) years and 96% were male. Program completers logged a mean (standard deviation) of 3.5 (1.4) exercise sessions and 150 (86) exercise minutes per week. The majority (84%) of program completers reported being satisfied overall with the program. Mean functional capacity improved by 1.0 metabolic equivalents (5.3 to 6.3, 95% confidence interval 0.3 to 1.7; p = 0.008) and mean systolic blood pressure at rest improved by 9.6mm Hg (mean difference 9.6, 95% confidence interval -19.0 to -0.7; p = 0.049) among completers. Smartphone-enabled, home-based CR is feasible in veterans with heart disease and is associated with moderate to high levels of engagement and patient satisfaction.

Trial registration: ClinicalTrials.gov NCT02791685.

PubMed Disclaimer

Conflict of interest statement

DISCLOSURES

Dr. Harzand reports the following activities with Moving Analytics: science advisory board, speaker’s bureau (modest), and shareholder (modest, non-fiduciary). None of the remaining authors report any potential conflicts of interest.

Figures

Figure 1.
Figure 1.
Smartphone-Enabled Platform with screenshots of (A) smartphone app with daily reminders for exercise, logging vitals and taking medications; (B) smartphone app 2-way messaging; and (C) online dashboard.
Figure 2.
Figure 2.
Mean change in METS achieved during ETT, at baseline and at 12 weeks; (MD 1, 95% CI, 0.3 to 1.7; P=0.008). Box plots show data for the cohort as a whole (N=13). Line plots show changes for individual participants. METS = metabolic equivalents; ETT = exercise treadmill testing
Figure 3.
Figure 3.
Changes in resting vital signs at baseline and at 12 weeks for those that completed the intervention (n=16) with (A) mean change in resting HR (0 BPM, 95% CI, −5.4 to 3.7); (B) mean change in resting SBP (MD 9.6, 95% CI −19.0 to −0.7; P=0.049); and (C) mean change in resting DBP (MD 4.3; 95% CI, −12.2 to 3.6; P=0.256). HR = heart rate; BPM = beats per minute; SBP = systolic blood pressure; DBP = diastolic blood pressure
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Thomas RJ, King M, Lui K, Oldridge N, Pina IL, Spertus J. AACVPR/ACC/AHA 2007 performance measures on cardiac rehabilitation for referral to and delivery of cardiac rehabilitation/secondary prevention services. Circulation 2007;116:1611–1642. - PubMed
    1. Anderson L, Oldridge N, Thompson DR, Zwisler A- D, Rees K, Martin N, Taylor RS. Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis. Journal of the American College of Cardiology 2016;67:1–12. Available at: http://linkinghub.elsevier.com/retrieve/pii/S0735109715071193. Accessed January 2, 2017. - PubMed
    1. Schopfer DW, Takemoto S, Allsup K, Helfrich CD, Ho PM, Forman DE, Whooley MA. Cardiac rehabilitation use among veterans with ischemic heart disease. JAMA Intern Med 2014;174:1687–1689. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25133868. - PubMed
    1. Suaya JA, Shepard DS, Normand S- LT, Ades PA, Prottas J, Stason WB, Mech LD, Edwards-Stewart A, Smolenski DJ, Reger GM, Bush N, Workman DE, Assari S, Suaya JA, Shepard DS, Normand S- LT, Ades PA, Prottas J, Stason WB, Affairs V, Veterans M, Zutz A, Ignaszewski A, Bates J, Lear SA, Beatty AL, Fukuoka Y, Whooley MA, Widmer RJ, Collins NM, Collins CS, West CP, Lerman LO, Lerman A, Allison TG, Lopez-Jimemez F, Lennon R, Lerman LO, Lerman A, Worringham C, Rojek AA, Stewart I, Walters DL, Sarela A, Fairfull A, Neighbour K, Cowen C, Stephens B, Sellwood T, Sellwood B, et al. Use of Cardiac Rehabilitation by Medicare Beneficiaries After Myocardial Infarction or Coronary Bypass Surgery. Circulation 2007;116:1653–1662. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17893274. Accessed January 22, 2017. - PubMed
    1. Klein S The Veterans Health Administration: implementing patient-centered medical homes in the nation’s largest integrated delivery system. The Commonwealth Fund 2011. Available at: https://pdfs.semanticscholar.org/a8d6/25b4af74848703ccfe61a4e3561a71e91e.... Accessed May 31, 2017.

Publication types

Associated data