Abstract P342: Virtual Cardiac Rehabilitation For Heart Failure - Real World Experience Of Medication Adherence, Blood Pressure Control And Exercise Tolerance

Abstract

Introduction: India has a high burden of young-onset heart failure owing to an increased incidence of ischemic heart disease(IHD) in young and older adults (<60 years). Hypertension affects 207 million adults in India; less than 20% have controlled blood pressure. Cardiac rehabilitation (CR) effectively improves outcomes in patients with heart failure but is very scarce; there is only one spot for every 360 IHD patients/year, with more than 3 million CR spaces needed each year. Methods: Virtual cardiac rehabilitation is administered via a mobile application, Numen Health. This is a physician-led program delivered by a multi-disciplinary team of experts. The experts provide multi-faceted interventions for IHD patients, targeting increased medication adherence, behavior changes, reinforced lifestyle modification, blood pressure control through diet, exercise, and building mental resilience with continued care post-hospital discharge. Results: Between April 2021 and March 2022, 42 patients with low ejection fraction (LVEF<45%) heart failure registered on the program. They represented nearly 10% of 426 IHD patients who had joined the program. Over a median duration of 90 days, target blood pressure control was achieved in 39/42 (93%). Zero hospital re-admissions were encountered; 17/42(40%) achieved improved cardiac and exercise tolerance compared to baseline exercise tolerance time. It had increased from 15 minutes to 30 minutes, 200% from baseline. The median MET score on day 90 was 13 (9-17). Physical activity duration per week increased; to 90 minutes on average; It had risen from the ability to do for <5 minutes at baseline. Medication adherence and clinical follow-up were 100% of the prescribed. A self-rated satisfaction scale scored the program at 90 - 95 /100 on day 30 by all. Conclusions: Virtual Cardiac Rehabilitation in India is feasible and possibly effective in delivering integrated CR services at home. Numen health shows promise in bridging the gap of negligent CR services across India.