Widmer R Jay, Senecal Conor, Allison Thomas G, Lopez-Jimenez Francisco, Lerman Lilach O, Lerman Amir
Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States.
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, United States.
J Med Internet Res. 2020 Feb 26;22(2):e13055. doi: 10.2196/13055.
Previous data have validated the benefit of digital health interventions (DHIs) on weight loss in patients following acute coronary syndrome entering cardiac rehabilitation (CR).
The primary purpose of this study was to test the hypothesis that increased DHI use, as measured by individual log-ins, is associated with improved weight loss. Secondary analyses evaluated the association between log-ins and activity within the platform and exercise, dietary, and medication adherence.
We obtained DHI data including active days, total log-ins, tasks completed, educational modules reviewed, medication adherence, and nonmonetary incentive points earned in patients undergoing standard CR following acute coronary syndrome. Linear regression followed by multivariable models were used to evaluate associations between DHI log-ins and weight loss or dietary adherence.
Participants (n=61) were 79% male (48/61) with mean age of 61.0 (SD 9.7) years. We found a significant positive association of total log-ins during CR with weight loss (r=.10, P=.03). Educational modules viewed (r=.11, P=.009) and tasks completed (r=.10, P=.01) were positively significantly associated with weight loss, yet total log-ins were not significantly associated with differences in dietary adherence (r=.05, P=.12) or improvements in minutes of exercise per week (r=.03, P=.36).
These data extend our previous findings and demonstrate increased DHI log-ins portend improved weight loss in patients undergoing CR after acute coronary syndrome. DHI adherence can potentially be monitored and used as a tool to selectively encourage patients to adhere to secondary prevention lifestyle modifications.
ClinicalTrials.gov (NCT01883050); https://clinicaltrials.gov/ct2/show/NCT01883050.
既往数据已证实数字健康干预（DHI）对急性冠状动脉综合征后进入心脏康复（CR）的患者体重减轻有益。
本研究的主要目的是检验以下假设，即通过个人登录次数衡量的DHI使用增加与体重减轻改善相关。次要分析评估了登录次数与平台内活动以及运动、饮食和药物依从性之间的关联。
我们获取了急性冠状动脉综合征后接受标准CR的患者的DHI数据，包括活跃天数、总登录次数、完成的任务、查看的教育模块、药物依从性以及获得的非货币激励积分。采用线性回归和多变量模型来评估DHI登录次数与体重减轻或饮食依从性之间的关联。
参与者（n = 61）中79%为男性（48/61），平均年龄为61.0（标准差9.7）岁。我们发现CR期间的总登录次数与体重减轻之间存在显著正相关（r = 0.10，P = 0.03）。查看的教育模块（r = 0.11，P = 0.009）和完成的任务（r = 0.10，P = 0.01）与体重减轻呈显著正相关，但总登录次数与饮食依从性差异（r = 0.05，P = 0.12）或每周运动分钟数的改善（r = 0.03，P = 0.36）无显著关联。
这些数据扩展了我们之前的发现，并表明DHI登录次数增加预示着急性冠状动脉综合征后接受CR的患者体重减轻改善。DHI依从性可潜在地进行监测，并用作选择性鼓励患者坚持二级预防生活方式改变的工具。
ClinicalTrials.gov（NCT01883050）；https://clinicaltrials.gov/ct2/show/NCT01883050
