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

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 Activeme, were used without knowing their benefits. We assessed changes in patient activation measure (PAM) in patients participating in routine CR, using Activeme. We also investigated changes in PAM among low, moderate, and high risk patients, changes in cardiovascular risk factors, and explored patient and healthcare professional experiences of using Activeme.

METHODS

Patients received standard CR education and an exercise prescription. Activeme was used to monitor patient health, progress towards goals, and provide additional lifestyle support. Patients accessed Activeme through a smart-device application which synchronised to telemetry enabled scales, blood pressure monitors, pulse oximeter, and activity trackers. Changes in PAM score following CR were calculated. Sub-group analysis was conducted on patients at high, moderate, and low risk of exercise induced cardiovascular events. Qualitative interviews explored the acceptability of Activeme.

RESULTS

Forty-six patients were recruited (Age: 60.4 ± 10.9 years; BMI: 27.9 ± 5.0 kgm; 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). Activeme was acceptable to patients and healthcare professionals.

CONCLUSION

Participation in standard CR, with Activeme, is associated with increased patient skill, knowledge, and confidence to manage their condition. Activeme may be an appropriate platform to support CR delivery when patients cannot be seen face-to-face.

TRIAL REGISTRATION

As this was not a clinical trial, the study was not registered in a trial registry.