Role of an e-Health Intervention in Holistic Healthcare: A Quasiexperiment in Patients Undergoing Cardiac Catheterization in Taiwan

Abstract

Background. The use of electronic health (e-health) resources is emerging as an alternative method to improve the secondary prevention of coronary artery disease (CAD). The aim of this study was to describe the influence of an e-health application in holistic healthcare for patients with CAD. Methods. A quasiexperiment with nonequivalent groups design recruited outpatients with a high risk of CAD admitted for cardiac catheterization. They were divided into two groups. Before the procedure, the control group received traditional patient education, and the intervention group watched videos on Internet-based social media. EQ-5D and FACIT–Sp-12 questionnaires were used as outcome measures of interest, and they were administered before and after the procedure and at the first return visit to the outpatient clinic after discharge. The effect of each intervention was tested using a linear mixed effects model. In addition, the 90-day readmission rate was also studied. Results. A total of 300 patients were divided into intervention and control groups (150 patients in each group). The interaction effect of EQ-5D was not statistically significant; however, improvements in FACIT–Sp-12 were greater in the intervention group from baseline to before discharge (regression coefficient (B) = 1.70, $p<0.001$ ) and from baseline to postdischarge first outpatient visit (B = 1.81, $p<0.001$ ). Moreover, the 90-day readmission rate was significantly lower in the intervention group (14% vs. 18.7%; $p=0.016$ , log-rank test). Conclusions. e-health intervention with easily accessible Internet-based social media is a promising model to meet the holistic needs of patients with CAD in the modern era.