The Efficacy of the Smart-Rehabilitation Program in Patients After the Correction of Valvular Heart Diseases

Abstract

Aim      Comparative analysis of the effectiveness of a new approach, "SMART rehabilitation of patients after heart valve replacement", which includes, in addition to face-to-face training, Internet technologies in the form of video conferencing, the mobile application "Calculation of the warfarin dose", and a traditional program for educating patients after correction of valvular defects.Material and methods  The study included 190 patients with prosthetic heart valves. The main group consisted of 98 patients who completed a distance learning course. The control group included 92 patients participating in face-to-face training. Clinical and instrumental examinations (electrocardiography, echocardiography, determination of international normalized ratio (INR)), and surveys to evaluate awareness, compliance with treatment, and quality of life (QoL) were performed.Results At baseline, the awareness, compliance and QoL did not differ between the compared groups. After 6-month follow-up, the mean score of awareness increased by 53.6 % (р=0.0001). The compliance with treatment increased 3.3 times in the main group and 1.7 times in the control group (p=0.0247). Patients of the main group were more prone to self-management (p=0.0001), had better medical and social awareness (p=0.0335), medical and social communicability (p=0.0392), confidence in the therapeutic strategy of the attending physician (p=0.0001), and treatment effectiveness (p=0.0057). Analysis of QoL showed increases in living activity 2.1 times (р=0.0001), social functioning 1.6 times (р=0.0001), and mental health 1.9 times (р=0.0001).Conclusion      The novel approach of distance learning, "SMART rehabilitation of patients after heart valve replacement", provides improvements in awareness, compliance with treatment and QoL.