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Table 4 Summary of outcome results in cardiac rehabilitation studies

From: Smartphones in the secondary prevention of cardiovascular disease: a systematic review

 

Worringham, 2011 (FUU)

Forman, 2014 (FUU)

Varnfield, 2011 (FUU)

Blasco, 2012 (RCT)

Varnfield, 2014 (RCT)

Patient numbers n =

6

26

15

102 TMG; 101CG

60 CAP; 60 TCR

Program completion

100%

NR

Internal feasibility study

87%

TMG: 88% (n = 90 of 102) CG: 87% (n = 88 of 101, includes 4 deaths) or 91% (n 92 of 101, excludes 4 deaths)

++

TMG: 80% (n 48 = of 60) vs CG: 47% (n = 28 of 60)

Mean age (years)

53.6 (42–67)

59 (43–76) 33% > 65 years

59

60.6 ± 1.3 TMG 61.0 ± 12.1 CG

54.9 ± 9.6 CAP 56.2 ± 10.1 TCR

Technology (reported inconsistently)

Feasibility

✓

✓

NR

  

Usability/Acceptability

4.8/5.0 Ease of use

83% positive experience

Easy (qualitative data)

  

Technical

80% of completed sessions had no technical problems

NR

36% use of Wellness Diary Connected internet -limited by computer and internet access

42% of TMG withdrawals due to technical issues (n = 5 of 12)

7% of CAP withdrawals reported technical difficulties

Engagement/Adherence/Usage/Task completion

87% completed sessions

90% daily engagement

78% task completion

91.5% wellness diary

100% step counter

98% completed > 50% sessions

83% completed > 75% of sessions

++

(94% vs 68% adherence)

Patient

Uptake

86% of referred patient

 

Internal feasibility study

83.5%

++

(80% vs 62%)

Mentorship

  

91% motivational

  

CV risk improvement

   

++ (ITT)

 

Physical activity

   

ns

 

6 Minute Walk Test

+

   

ǂ †

ns

Nutrition

    

ǂ †

ns

Smoking cessation

   

ns (ITT)

 

Psychological distress

    

Ç‚

ns

Depression

+

   

ǂ †

ns

Anxiety

    

Ç‚

ns

Quality of Life

+ − physical health

ns - mental health

(SF36)

  

++ Physical health

ns Mental health

(SF36)

Ç‚

++

(EQ5D-Index)

Blood pressure (BP) and Heart rate (HR)

   

++ BP (ITT)

++ SBP

≠ DBP

++ DBP

ns HR

ns SBP

Weight

    

Ç‚

ns

Body Mass Index

   

++

 

Waist circumference

    

Ç‚

ns

Haemoglobin A1c (HbA1c)

   

++ (ITT)

++

ns

Plasma lipid level

   

ns LDL-c (ITT)

++ LDL-c

++ TG

† ns TC

ǂ † ≠ TG

ns LDL-c

  1. Key: FUU Feasibility, Utility and Uptake study, RCT Randomised Control Trial, TMG Telemonitoring Group, CAP Care Assessment Platform cardiac rehabilitation, TCR Traditional Cardiac Rehabilitation, CG Control Group, PROs Patient reported outcomes, CV Cardiovascular, LDL-c Low density lipoprotein cholesterol, TG Triglyceride
  2. FUU studies - pre- compared with post-intervention: + = significant improvement with mHealth; # = no significant improvement with mHealth; NR = not reported; ✓ = reported as feasible
  3. RCT studies: ++ = significant improvement in mHealth group compared with TCR (or CG) group; ns = no significant difference between mHealth group and TCR (or CG) group; ≠ = significant improvement in TCR (or CG) compared with mHealth group; ǂ = significant CAP within-group differences at 6 weeks; † = significant TCR within-group differences at 6 weeks; ITT = Intention to treat analysis