Abstract
Objective: To examine whether mobile technology improves adherence to cardiac rehabilitation and other outcomes. Methods: We identified enrollees of the cardiac rehabilitation program at Boston Medical Center from 2016-2020 (n=830). Some enrollees used a mobile technology application (Wellframe.com) that provided a customized interactive list of educational content in a progressive manner, used the patient’s smart phone accelerometer to provide daily step counts, and served as a two-way messaging system between the patient and the program staff. Adherence to cardiac rehabilitation was defined as the number of attended prescribed sessions and completion of the program. To evaluate change in the following: exercise capacity, Beck Depression Index (BDI) scores, weight, quality of life scores and Rate Your Plate nutrition scores, we used the generalized estimating equation method. Results: After 2:1 propensity score matching for age, sex, race, education, smoking status, transportation time to cardiac rehabilitation center, qualifying diagnosis, and baseline BDI score, there were 121 enrollees in the group using the Wellframe application as a supplement to the rehabilitation program and 280 enrollees in the Standard rehabilitation group. Enrollees had a mean age of 59 years; 32% were women, and 42% were black. Those in the mobile technology group attended a higher number of prescribed sessions (mean 28 vs. 22), RR: 1.17 (95% CI: 1.04-1.32, p=0.009), were 1.8 times more likely to complete the cardiac rehabilitation program (p=0.01), and had a slightly greater weight loss (lbs) post rehabilitation: -1.71 (95% CI: -0.30, -3.11, p=0.02) as compared to those in the Standard group; other outcomes were similar between the groups (Table 1). Conclusion: In a propensity-matched, racially diverse population, we found that adjunctive use of mobile technology significantly improved adherence to cardiac rehabilitation and number of attended sessions.
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