Features of remote rehabilitation using the developed mobile app in patients after cardiac bypass surgery

Abstract

Abstract Aim of the study The aim of the study is to evaluate the features and availability of the developed remote rehabilitation program with the use of a mobile application in patients who have undergone coronary artery bypass surgery (CABG) and surgical correction of valvular heart disease (VHD). Material and methods of research In the current epidemiological situation, to increase the availability of cardiorehabilitation for patients after open heart surgery, a mobile application with the program “Remote rehabilitation of patients who have undergone heart surgery” was developed. The remote rehabilitation program included 46 patients (median age 60.0 [53.0; 64.0]) who underwent cardiac surgery. Of these, 22 patients after CABG (median age 61.0 [53.0; 63.5]) and 24 patients after surgical correction of VHD (median age 59.5 [54.0; 63.75]). On the 5th day after the surgery, the developed application for remote rehabilitation was installed on the smartphone. It consisted of 5 sections: Dosed Walking, Therapeutic gymnastics, Diet, Psychology and Chat. After application installing and until the moment of discharge from the hospital, 3 classes with a total duration of 6 academic hours were conducted with each patient. After being discharged from the hospital the patients were recommended to use the mobile app for rehabilitation at home for 4 months. 4 months after the surgery the app usage statistics were evaluated and a telephone survey of the reasons for non-complience was conducted. Results A total of 34 (74%) patients used the mobile app for remote rehabilitation. Of these, 24 (52.0%) used the app section “Dosed Walking” and “Therapeutic Gymnastics” at least 5 times a week for 4 months, 10 (22%) used the app no more than 10 times during the entire follow-up period, and 12 (26%) did not engage in remote rehabilitation using the app. 22% of patients received consultations with a cardiologist via chat in mobile app. The telephone survey revealed the main reasons for the irregular participation of patients in the remote rehabilitation program using the mobile app: lack of interest/desire to engage in physical rehabilitation – 16 (35%), problems with the Internet – 6 (13%), lack of time – 4 (8.5%), incorrect function of the app – 4 (8.5%). Conclusions Insufficient adherence of patients after cardiac surgery to a remote rehabilitation program using a mobile application, associated with a lack of motivation in patients, was demonstrated. This implies the importance of developing and implementing further measures to increase the motivation and adherence of patients to participate in long-term remote cardiac rehabilitation programs. Funding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): Russian Federation President grant