Table 2 Overview of the HeartMan intervention components
Intervention component | Strategy | Description of the intervention |
|---|---|---|
Nutrition | Education on: - knowledge of healthy nutrition - eating behavior | - Questionnaire to evaluate knowledge and healthy behavior ○ Baseline and end of the trial - Personalized feedback and education is coupled to the questionnaire - Possibility to consult questionnaire and education material via the application on a voluntary basis during the trial |
Exercise | Endurance exercise | - Assessment of physical capacity: cyclo-ergometry (if available) and 6MWT - Differentiation based on baseline physical capacity level (low level: cyclo-ergometry < 1 W/kg or 6MWT < 300 m vs. normal level: ≥1 W/kg or 6MWT ≥300 m) - Individual exercise program via the application: ○ Frequency: 2–5 times per week ○ Intensity: HR rest + 40–70% HRR or RPE 10–14/20 ○ Time: 10-40 min ○ Type: cycling, walking, steps - Individual progress: ○ Increase in frequency or time after a predefined number of weeks (after patient’s approval) ○ Increase in intensity if following criteria are met: • Adherence to exercise therapy > 60% of training sessions • Not overshooting the target heart rate in 80% of the training sessions • Patient’s subjective opinion of exercise intensity: ‘no discomfort’ in 80% of the training sessions • After at least 8 weeks of exercise training |
Resistance exercise | - Differentiation based on baseline physical capacity level - Individual exercise program via the application: ○ Frequency: 2–3 times per week ○ Intensity: 60–70% 1Repetition maximum ○ Time: 1–2 sets per day ○ Type: dynamic upper and lower limb exercises, with no or light weights - Individual progress: ○ Increase in frequency or time after a predefined number of weeks (after patient’s approval) ○ Increase in intensity (from no weights to light weights) after a predefined number of weeks (after patient’s approval) | |
Medication intake | Weekly pill organizer | - Passive pill dispenser, with personalized reminder function in HeartMan application: ○ Guidance to prepare medication once per week ○ Daily personalized notifications to remind the patient to take his medication at the right time - Assessment of medication adherence by a weekly question whether the patient has taken the recommended medication or not |
Appointments | - Personalized reminder function in HeartMan application 1 day before the appointment (only upon the patient’s request) | |
Mental support | Cognitive behavioral therapy | - Patient profiling: adaption of the communication according to the psychological profile (anxious, depressed or low motivation) in order to increase adherence to lifestyle interventions |
Mindfulness exercises | - Mindfulness exercises are offered to the patient on a daily basis, adapted to the patient’s profile (anxious, depressed or motivated). - Different types of exercises: ○ Listening ○ Focusing ○ Awareness ○ Games | |
Disease education (illness perception) | Education on: - Heart failure disease: causes, symptoms - Pharmacological treatment: indications, common side effects - Sexual dysfunction and sexual activity | - Written education in a depository - To consult on a voluntary basis |