Abstract
Objectives:To determine the effectiveness of Mobile health augmented Cardiac rehabilitation (MCard) on health-related quality of life (HRQoL) among post-acute coronary syndrome (post-ACS) patients.Methods:At the Armed Forces Institute of Cardiology (AFIC), a tertiary care hospital in Rawalpindi, Pakistan, a two-arm randomised controlled trial was conducted in which mobile health augmented cardiac rehabilitation (MCard) was developed and implemented on post-ACS patients from January 2019 until March 2021. The trial conforms to the CONSORT statement 2010. The post-ACS patients were randomly allocated (1:1) to an intervention group (received MCard; counselling, empowering with self-monitoring devices, short text messages, in addition to standard post-ACS care) or control group (standard post-ACS care). HRQoL was assessed by generic Short Form-12 and MacNew quality of life myocardial infarction (QLMI) tools. Participants were followed for 24 weeks with data collection and analysis at three time points (baseline, 12 weeks and 24 weeks).Results:At baseline, 160 patients (80 in each group; mean age 52.66±8.46 years; 126 male, 78.75%) were recruited, of which 121(75.62%) continued and were analysed at 12-weeks and 119(74.37%) at 24-weeks. The mean SF-12 physical component score significantly improved in the MCard group at 12 weeks follow-up (48.93 vs control 43.87, p<.001) and 24 weeks (53.52 vs 46.82 p<.001). The mean SF-12 mental component scores also improved significantly in the MCard group at 12 weeks follow-up (44.84 vs control 41.40, p<.001) and 24 weeks follow-up (48.95 vs 40.12, p<.001). At 12-and 24-week follow-up, all domains of MacNew QLMI (social, emotional, physical and global) were also statistically significant (p<.001) improved in the MCard group, unlike the control group.Conclusion:MCard is an effective and acceptable intervention at improving all domains of HRQoL. There was an improvement in physical, mental, social, emotional and global domains among the MCard group in comparison to the control group. The addition of MCard programs to post-ACS standard care may improve patient outcomes and reduce the burden on the health care setting.
Highlights
Cardiovascular diseases (CVDs) are the major public health problem, claiming the lives of 17.9 million people per year worldwide
At the Armed Forces Institute of Cardiology (AFIC), a tertiary care hospital in Rawalpindi, Pakistan, a two-arm randomised controlled trial was conducted in which mobile health augmented cardiac rehabilitation (MCard) was developed and implemented on post-Acute coronary syndrome (ACS) patients from January 2019 until March 2021
The trial is registered in the Australian New Zealand Clinical Trial Registry (ANZCTR) (ACTRN12619001731189).[15]
Summary
Cardiovascular diseases (CVDs) are the major public health problem, claiming the lives of 17.9 million people per year worldwide. Pak J Med Sci March - April 2022 Vol 38 No 3 www.pjms.org.pk 716 of the most common CVDs, which affects about 12 million people annually, with 600,000 of them dying.[2] These premature deaths can be minimised by using population-wide approaches to mitigate lifestyle risk factors, namely tobacco use, sedentary lifestyle and malnutrition, physical inactivity, and harmful alcohol use. HRQoL is a multidimensional term that encompasses a person’s physical, emotional, and social well-being that is a well-known indicator of mortality in the general population and mortality and morbidity after ACS diagnosis or related event.[5] As a secondary preventive measure, CR is a professionally administered programme first introduced in the 1960s and 1970s as a critical tool for stabilising patients following a severe cardiac event (myocardial infarction or cardiac surgery).[6]
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