Smartphone-based cardiac rehabilitation and secondary prevention for coronary heart disease appears to be an option to improve outcomes following percutaneous coronary interventions in low to middle income countries.
A Curtin University-led study in China found the rehab, delivered by the popular Chinese messaging and social media app WeChat, improved functional capacity and secondary prevention targets at two and six months.
The study, published in The Lancet Digital Health, randomised 312 patients with coronary heart disease from a tertiary hospital in Shanghai to either the smartphone-based rehabilitation and secondary prevention program or usual care.
The intervention comprised two months of intensive rehab then four months of a step-down support. It included core components of contemporary cardiac rehabilitation such as education about cardiovascular health and disease, physical activity prescription, nutritional advice, and support for medication adherence, psychological wellbeing, and modification of coronary heart disease risk factors.
Other features included WeChat’s built-in pedometer function to monitor physical activity, WeChat-interfaced blood pressure and heart rate monitoring and a system of alerts to reinforce behaviour change.
In contrast, usual care was typically a brief inpatient health education provided by a nurse, medication management, and ad-hoc follow-up visits to a cardiologist or other health professional based on the patient’s self-assessment of their cardiovascular health.
The study found patients in the rehabilitation and secondary prevention program had an improved six-minute walk distance at both two and six months compared to the usual care group.
They also had lower blood pressure and resting heart rates than the usual care group, improved knowledge of coronary heart disease and better adherence to cardioprotective medications.
By 12 months, the intervention group also had a more favourable lipid profile than the usual care group.
Co-author Associate Professor Andrew Maiorana, from the School of Physiotherapy and Exercise Science at Curtin University, told the limbic that while there have been a number of promising studies in recent years looking at text messaging support for cardiac rehab, no one has used a social media platform before.
“We were hopeful that we would be able to deliver an effective program using social media, and specifically WeChat, but we weren’t sure so we are really pleased with how much engagement that we got with people through that project.”
He said one of the novel aspects to the project was that it was basically run by Shanghai cardiologist Dr Tashi Dorje from Perth while he was PhD candidate at Curtin University.
“It’s quite a unique aspect to being able to use technology in digital health like this. You can provide good patient support remotely from the other side of the world.”
And there were local implications given digital health was an emerging area in the management of a range of different chronic diseases.
“I think a program of this nature could be adapted to the Australian context using something like Facebook – providing not only information and support but linking patients into support networks among other patient groups as well. That’s something we look forward to exploring in our future research.”