The Delivery of Cardiac Rehabilitation Using Communications Technologies: The “Virtual” Cardiac Rehabilitation Program
Cardiac rehabilitation (CR) programs are a proven therapy for patients with cardiovascular disease, reducing future cardiac events and premature mortality. However, as little as 10% of eligible patients attend these programs, with a key reason being geographical inaccessibility. In Canada, more than...
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| Veröffentlicht in: | Canadian journal of cardiology Jg. 34; H. 10; S. S278 - S283 |
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| Format: | Journal Article |
| Sprache: | Englisch |
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Elsevier Inc
01.10.2018
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| ISSN: | 0828-282X, 1916-7075, 1916-7075 |
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| Abstract | Cardiac rehabilitation (CR) programs are a proven therapy for patients with cardiovascular disease, reducing future cardiac events and premature mortality. However, as little as 10% of eligible patients attend these programs, with a key reason being geographical inaccessibility. In Canada, more than 90% of Canadians have Internet access, and there are approximately 31 million cell phone subscribers, with these numbers expected to continue to increase. The proliferation of these affordable communications technologies has opened up opportunities for patient communication while bridging geographic distance. This has led to the development of “virtual” CR that can be remotely conducted, reaching patients in their homes and communities. These programs have used a range of technologies such as telephone, Internet, text messaging, and smartphones. Early research has focused on acceptance of use and feasibility in pilot studies, indicating patient willingness for use. More recently, a number of small, randomized trials have been conducted indicating potential positive effect on various clinical outcomes. This narrative review highlights the evidence to date on the use of virtual CR, using a variety of affordable communications technologies from early feasibility studies to modest randomized controlled trials. Finally, lessons from previous studies are discussed to help inform the development and testing of future virtual CR. This will be important if virtual CR is to become part of standard health care.
Les programmes de réadaptation cardiaque (RC) sont reconnus pour le traitement des patients atteints d’une maladie cardiovasculaire, et contribuent à réduire les événements cardiaques et la mortalité prématurée. Toutefois, aussi peu que 10 % des patients admissibles participent à ces programmes, principalement en raison de l’inaccessibilité géographique. Au Canada, on compte déjà plus de 90 % de Canadiens qui ont accès à Internet et environ 31 millions qui utilisent un téléphone cellulaire, mais on s’attend à ce que ces chiffres continuent à augmenter. La prolifération de ces technologies de communication abordables a ouvert des perspectives de communication avec les patients, tout en comblant la distance géographique. Le développement de programmes de RC « virtuelle » qui en a découlé a permis d’effectuer la RC à distance en joignant les patients chez eux ou dans leur collectivité. Ces programmes ont utilisé un éventail de technologies comme le téléphone, l’Internet, la messagerie texte et les téléphones intelligents. Les premiers résultats des études pilotes qui ont surtout porté sur l’acceptation de l’utilisation et la faisabilité ont montré la volonté des patients à les utiliser. Plus récemment, les nombreux essais à répartition aléatoire de petite taille qui ont été réalisés ont montré des effets positifs potentiels sur les différents résultats cliniques. La présente revue narrative porte principalement sur les données probantes actuelles sur le recours à la RC virtuelle en utilisant diverses technologies de communication abordables issues des études de faisabilité initiales aux modestes études cliniques à répartition aléatoire. Finalement, nous nous penchons sur les leçons tirées des études précédentes pour contribuer au développement et à la mise à l’essai d’un futur programme de RC virtuelle. Cela sera important si la RC virtuelle doit faire partie des soins de santé courants. |
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| AbstractList | Cardiac rehabilitation (CR) programs are a proven therapy for patients with cardiovascular disease, reducing future cardiac events and premature mortality. However, as little as 10% of eligible patients attend these programs, with a key reason being geographical inaccessibility. In Canada, more than 90% of Canadians have Internet access, and there are approximately 31 million cell phone subscribers, with these numbers expected to continue to increase. The proliferation of these affordable communications technologies has opened up opportunities for patient communication while bridging geographic distance. This has led to the development of "virtual" CR that can be remotely conducted, reaching patients in their homes and communities. These programs have used a range of technologies such as telephone, Internet, text messaging, and smartphones. Early research has focused on acceptance of use and feasibility in pilot studies, indicating patient willingness for use. More recently, a number of small, randomized trials have been conducted indicating potential positive effect on various clinical outcomes. This narrative review highlights the evidence to date on the use of virtual CR, using a variety of affordable communications technologies from early feasibility studies to modest randomized controlled trials. Finally, lessons from previous studies are discussed to help inform the development and testing of future virtual CR. This will be important if virtual CR is to become part of standard health care.Cardiac rehabilitation (CR) programs are a proven therapy for patients with cardiovascular disease, reducing future cardiac events and premature mortality. However, as little as 10% of eligible patients attend these programs, with a key reason being geographical inaccessibility. In Canada, more than 90% of Canadians have Internet access, and there are approximately 31 million cell phone subscribers, with these numbers expected to continue to increase. The proliferation of these affordable communications technologies has opened up opportunities for patient communication while bridging geographic distance. This has led to the development of "virtual" CR that can be remotely conducted, reaching patients in their homes and communities. These programs have used a range of technologies such as telephone, Internet, text messaging, and smartphones. Early research has focused on acceptance of use and feasibility in pilot studies, indicating patient willingness for use. More recently, a number of small, randomized trials have been conducted indicating potential positive effect on various clinical outcomes. This narrative review highlights the evidence to date on the use of virtual CR, using a variety of affordable communications technologies from early feasibility studies to modest randomized controlled trials. Finally, lessons from previous studies are discussed to help inform the development and testing of future virtual CR. This will be important if virtual CR is to become part of standard health care. Cardiac rehabilitation (CR) programs are a proven therapy for patients with cardiovascular disease, reducing future cardiac events and premature mortality. However, as little as 10% of eligible patients attend these programs, with a key reason being geographical inaccessibility. In Canada, more than 90% of Canadians have Internet access, and there are approximately 31 million cell phone subscribers, with these numbers expected to continue to increase. The proliferation of these affordable communications technologies has opened up opportunities for patient communication while bridging geographic distance. This has led to the development of “virtual” CR that can be remotely conducted, reaching patients in their homes and communities. These programs have used a range of technologies such as telephone, Internet, text messaging, and smartphones. Early research has focused on acceptance of use and feasibility in pilot studies, indicating patient willingness for use. More recently, a number of small, randomized trials have been conducted indicating potential positive effect on various clinical outcomes. This narrative review highlights the evidence to date on the use of virtual CR, using a variety of affordable communications technologies from early feasibility studies to modest randomized controlled trials. Finally, lessons from previous studies are discussed to help inform the development and testing of future virtual CR. This will be important if virtual CR is to become part of standard health care. Les programmes de réadaptation cardiaque (RC) sont reconnus pour le traitement des patients atteints d’une maladie cardiovasculaire, et contribuent à réduire les événements cardiaques et la mortalité prématurée. Toutefois, aussi peu que 10 % des patients admissibles participent à ces programmes, principalement en raison de l’inaccessibilité géographique. Au Canada, on compte déjà plus de 90 % de Canadiens qui ont accès à Internet et environ 31 millions qui utilisent un téléphone cellulaire, mais on s’attend à ce que ces chiffres continuent à augmenter. La prolifération de ces technologies de communication abordables a ouvert des perspectives de communication avec les patients, tout en comblant la distance géographique. Le développement de programmes de RC « virtuelle » qui en a découlé a permis d’effectuer la RC à distance en joignant les patients chez eux ou dans leur collectivité. Ces programmes ont utilisé un éventail de technologies comme le téléphone, l’Internet, la messagerie texte et les téléphones intelligents. Les premiers résultats des études pilotes qui ont surtout porté sur l’acceptation de l’utilisation et la faisabilité ont montré la volonté des patients à les utiliser. Plus récemment, les nombreux essais à répartition aléatoire de petite taille qui ont été réalisés ont montré des effets positifs potentiels sur les différents résultats cliniques. La présente revue narrative porte principalement sur les données probantes actuelles sur le recours à la RC virtuelle en utilisant diverses technologies de communication abordables issues des études de faisabilité initiales aux modestes études cliniques à répartition aléatoire. Finalement, nous nous penchons sur les leçons tirées des études précédentes pour contribuer au développement et à la mise à l’essai d’un futur programme de RC virtuelle. Cela sera important si la RC virtuelle doit faire partie des soins de santé courants. Cardiac rehabilitation (CR) programs are a proven therapy for patients with cardiovascular disease, reducing future cardiac events and premature mortality. However, as little as 10% of eligible patients attend these programs, with a key reason being geographical inaccessibility. In Canada, more than 90% of Canadians have Internet access, and there are approximately 31 million cell phone subscribers, with these numbers expected to continue to increase. The proliferation of these affordable communications technologies has opened up opportunities for patient communication while bridging geographic distance. This has led to the development of "virtual" CR that can be remotely conducted, reaching patients in their homes and communities. These programs have used a range of technologies such as telephone, Internet, text messaging, and smartphones. Early research has focused on acceptance of use and feasibility in pilot studies, indicating patient willingness for use. More recently, a number of small, randomized trials have been conducted indicating potential positive effect on various clinical outcomes. This narrative review highlights the evidence to date on the use of virtual CR, using a variety of affordable communications technologies from early feasibility studies to modest randomized controlled trials. Finally, lessons from previous studies are discussed to help inform the development and testing of future virtual CR. This will be important if virtual CR is to become part of standard health care. |
| Author | Lear, Scott A. |
| Author_xml | – sequence: 1 givenname: Scott A. surname: Lear fullname: Lear, Scott A. email: slear@providencehealth.bc.ca organization: Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada, Division of Cardiology, Providence Health Care, Vancouver, British Columbia, Canada, and Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30274638$$D View this record in MEDLINE/PubMed |
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| Copyright | 2018 Canadian Cardiovascular Society Copyright © 2018 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved. |
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