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. 2024 Nov 14;6(1):115-125.
doi: 10.1093/ehjdh/ztae084. eCollection 2025 Jan.

An eHealth intervention for patients with a low socioeconomic position during their waiting period preceding cardiac rehabilitation: a randomized feasibility study

Jasper S Faber  1 , Jos J Kraal  1 , Nienke Ter Hoeve  2   3 , Isra Al-Dhahir  4 , Linda D Breeman  4 , Niels H Chavannes  5   6 , Andrea W M Evers  1   4   7 , Hans B J Bussmann  2 , Valentijn T Visch  1 , Rita J G van den Berg-Emons  2   3
Affiliations

An eHealth intervention for patients with a low socioeconomic position during their waiting period preceding cardiac rehabilitation: a randomized feasibility study

Jasper S Faber et al. Eur Heart J Digit Health. .

Abstract

Aims: Cardiac rehabilitation (CR) shows lower effectiveness and higher dropouts among people with a low socioeconomic position (SEP) compared to those with a high SEP. This study evaluated an eHealth intervention aimed at supporting patients with a low SEP during their waiting period preceding CR.

Methods and results: Participants with a low SEP in their waiting period before CR were randomized into an intervention group, receiving guidance videos, patient narratives, and practical tips, or into a control group. We evaluated adherence (usage metrics), acceptance (modified Usefulness, Satisfaction, and Ease of use questionnaire), and changes in feelings of certainty and guidance between the waiting period's start and end. Semi-structured interviews provided complementary insights. The study involved 41 participants [median interquartile range (IQR) age 62 (14) years; 33 males], with 21 participants allocated to the intervention group, using the eHealth intervention for a median (IQR) duration of 16 (10) days, using it on a median (IQR) of 100% (25) of these days, and viewing 88% of the available messages. Key adherence themes were daily routine compatibility and curiosity. Acceptance rates were 86% for usability, 67% for satisfaction, and 43% for usefulness. No significant effects on certainty and guidance were observed, but qualitative data suggested that the intervention helped to inform and set expectations.

Conclusion: The study found the eHealth intervention feasible for cardiac patients with a low SEP, with good adherence, usability, and satisfaction. However, it showed no effect on feelings of certainty and guidance. Through further optimization of its content, the intervention holds promise to improve emotional resilience during the waiting period.

Registration: This trial is registered as follows: 'Evaluation of a Preparatory eHealth Intervention to Support Cardiac Patients During Their Waiting Period (PReCARE)' at ClinicalTrials.gov (NCT05698121, https://clinicaltrials.gov/study/NCT05698121).

Keywords: Cardiac rehabilitation; Socioeconomic factors; Telemedicine; Time to treatment.

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Conflict of interest statement

Conflict of interest: none declared.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
A visual overview of patient enrolment and study procedures. CR, cardiac rehabilitation; CGQ, Certainty and Guidance Questionnaire.
Figure 2
Figure 2
Key interface screens from the CapriXpress intervention. From left to right: journey-based progression home page, done-pile tracker and travel bag, and multimedia messages from healthcare professionals.
Figure 3
Figure 3
Flowchart participant inclusion. Asterisk denotes 19 participants were included for the intervention adherence analysis.
Figure 4
Figure 4
Cumulative messages completed vs. days since the first usage (median ± interquartile range).
See this image and copyright information in PMC

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