Hisam Aliya, Haq Zia Ul, Aziz Sohail, Doherty Patrick, Pell Jill
Aliya Hisam, MBBS, MPH, FCPS, PhD Public Health. Associate Professor, Department of Community Medicine, Army Medical College, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan.
Prof. Zia Ul Haq, MBBS, MPH, PhD. Department of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan.
Pak J Med Sci. 2022 Mar-Apr;38(3Part-I):716-723. doi: 10.12669/pjms.38.3.4724.
To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome (post-ACS) patients.
At the Armed Forces Institute of Cardiology (AFIC), a tertiary care hospital in Rawalpindi, Pakistan, a two-arm randomised controlled trial was conducted in which mobile health augmented cardiac rehabilitation (MCard) was developed and implemented on post-ACS patients from January 2019 until March 2021. The trial conforms to the CONSORT statement 2010. The post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counselling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three time points (baseline, 12 weeks and 24 weeks).
At baseline, 160 patients (80 in each group; mean age 52.66±8.46 years; 126 male, 78.75%) were recruited, of which 121(75.62%) continued and were analysed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs control 43.87, p<.001) and 24 weeks (53.52 vs 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group.
MCard is an effective and acceptable intervention at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.
确定移动健康增强型心脏康复（MCard）对急性冠状动脉综合征（post-ACS）患者健康相关生活质量（HRQoL）的有效性。
在巴基斯坦拉瓦尔品第的一家三级护理医院武装部队心脏病学研究所（AFIC），进行了一项双臂随机对照试验，于2019年1月至2021年3月为post-ACS患者开发并实施了移动健康增强型心脏康复（MCard）。该试验符合2010年CONSORT声明。post-ACS患者被随机分配（1:1）至干预组（接受MCard；除标准的post-ACS护理外，还接受咨询、配备自我监测设备、接收短信息）或对照组（标准的post-ACS护理）。通过通用的简明健康调查问卷12（Short Form-12）和MacNew心肌梗死生活质量（QLMI）工具评估HRQoL。对参与者进行了24周的随访，并在三个时间点（基线、12周和24周）进行数据收集和分析。
在基线时，招募了160名患者（每组80名；平均年龄52.66±8.46岁；男性126名，占78.75%），其中121名（75.62%）继续参与研究，并在12周时进行了分析，119名（74.37%）在24周时进行了分析。在12周随访时，MCard组的简明健康调查问卷12身体成分平均得分显著改善（48.93对对照组43.87，p<0.001），在24周时（53.52对46.82，p<0.001）也是如此。MCard组的简明健康调查问卷12心理成分平均得分在12周随访时（44.84对对照组41.40，p<0.001）和24周随访时（48.95对40.12，p<0.001）也显著改善。在12周和24周随访时，与对照组不同，MCard组MacNew QLMI的所有领域（社会、情感、身体和总体）也有统计学意义的改善（p<0.001）。
MCard是一种有效且可接受的干预措施，可改善HRQoL的所有领域。与对照组相比，MCard组在身体、心理、社会、情感和总体领域均有改善。在post-ACS标准护理中增加MCard项目可能会改善患者预后并减轻医疗机构的负担。
