The Feasibility and Effects of Smartphone-Based Application on Cardiac Rehabilitation for Patients After Percutaneous Coronary Intervention

Abstract

Background Cardiac rehabilitation (CR) referral and participation are generally found to be underused worldwide. The data in Asian regions suggest significant underutilization compared with western countries. Objectives To promote the continuity and effects of CR, this study aimed at supporting self-care and improving CR effects in phase II CR with mobile health application for Macao patients who have undergone percutaneous coronary intervention. Methods The study was a randomized controlled trial conducted between January 2018 and June 2020 in a nongovernmental Hospital. Social cognitive theory was applied in the intervention for an experimental group. Measurements including anxiety and depression level, medication adherence, exercise capacity, physical activity level, cardiovascular risk modification, self-efficacy, quality of life, use of healthcare resources, mHealth CR utility, and satisfaction were analyzed. Results One hundred forty eligible patients were recruited, and 110 patients completed the study. Significant interventional effects of the experimental group were found on the reduction of total cholesterol, low-density lipoprotein, sitting time, anxiety level, and total anxiety and depression level (P < .05). In addition, significant improvement on the 6-minute walk test, regular exercise performance, self-efficacy of cardiac exercise and diet, and quality of life were found as interventional effects in the experimental group (P < .05). The feasibility of intervention was achieved in a satisfactory level. Conclusions This theoretically grounded mobile health CR study was a unique program tailor-made to meet the care needs of patients post percutaneous coronary intervention. It was feasible and effective to support CR effects and adherence and would inform further design of clinical practice and public policies.