Abstract 13732: A Mobile Intervention to Support Self-Care of Patients With Coronary Artery Disease: Preliminary Analysis of a Randomized Controlled Trial

Abstract

Background: Although cardiac rehabilitation is beneficial to all patients with coronary artery disease (CAD), due to the cost implications, such services are confined to those with an acute coronary event or heart failure exacerbation, which limits their accessibility and scalability. Hypothesis: Patients with CAD who receive the internet-based CArdiac Rehabilitation Enhancement (i-CARE) intervention would report better changes in self-care, functional status, health-related quality of life (HRQoL) and physiological biomarkers than those who receive usual care. Aims: This randomized controlled trial aimed to examine the effects of the i-CARE intervention on self-care behaviors, functional status, HRQoL, blood pressure, waist-to-height ratio and cholesterol level in patients with CAD. Methods: CAD patients were recruited in the cardiac clinic of two hospitals in Hong Kong. The intervention consisted of a single face-to-face orientation session and a mobile app consisting of three key user interfaces, including a self-monitoring dashboard with personalized interface according to their own risk profile, an interactive e-library covering various CAD-related self-care dimensions and a chat room for the nurse to provide continuous coaching. The control group received usual care. Results: A total of 132 patients with CAD were randomly allocated to the intervention (n = 68) or control group (n = 64). Compared to the control group, the intervention group showed greater improvements in self-care behaviors (β = 5.532, 95% CI: 1.735 - 14.241, p = 0.012), functional status (β = 2.235, 95% CI: 1.092 - 8.286, p = 0.033), HRQoL (β = 6.135, 95% CI: 1.830 - 12.843, p = 0.012), and blood pressure control (β = 12.584, 95% CI: 10.050 - 29.221, p = 0.041) at 12 weeks follow-up. No significant changes in cholesterol level and waist-to-height ratio were found. Conclusions: The i-Care intervention improves self-care behaviors, HRQoL, functional status and blood pressure control in patients with CAD. It is warranted to examine the longer-term effects of the i-CARE intervention.