Home-Based Rehabilitation With Telemonitoring Guidance for Patients With Coronary Artery Disease (Short-Term Results of the TRiCH Study): Randomized Controlled Trial.

Andrea Avila,Véronique Cornelissen,Roselien Buys,May Azzawi,Jomme Claes,Luc Vanhees,Kaatje Goetschalckx

doi:10.2196/jmir.9943

Andrea Avila, Véronique Cornelissen + Show 5 more

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https://doi.org/10.2196/jmir.9943

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Abstract

BackgroundCardiac rehabilitation (CR) is an essential part of contemporary coronary heart disease management. However, patients exiting a center-based CR program have difficulty retaining its benefits.ObjectiveWe aimed to evaluate the added benefit of a home-based CR program with telemonitoring guidance on physical fitness in patients with coronary artery disease (CAD) completing a phase II ambulatory CR program and to compare the effectiveness of this program in a prolonged center-based CR intervention by means of a randomized controlled trial.MethodsBetween February 2014 and August 2016, 90 CAD patients (unblinded, mean age 61.2 years, SD 7.6; 80/90, 89.0% males; mean height 1.73 m, SD 0.7; mean weight 82.9 kg, SD 13; mean body mass index 27.5 kg/m2, SD 3.4) who successfully completed a 3-month ambulatory CR program were randomly allocated to one of three groups: home-based (30), center-based (30), or control group (30) on a 1:1:1 basis. Home-based patients received a home-based exercise intervention with telemonitoring guidance consisting of weekly emails or phone calls; center-based patients continued the standard in-hospital CR, and control group patients received the usual care including the advice to remain physically active. All the patients underwent cardiopulmonary exercise testing for assessment of their peak oxygen uptake (VO2 P) at baseline and after a 12-week intervention period. Secondary outcomes included physical activity behavior, anthropometric characteristics, traditional cardiovascular risk factors, and quality of life.ResultsFollowing 12 weeks of intervention, the increase in VO2 P was larger in the center-based (P=.03) and home-based (P=.04) groups than in the control group. In addition, oxygen uptake at the first (P-interaction=.03) and second (P-interaction=.03) ventilatory thresholds increased significantly more in the home-based group than in the center-based group. No significant changes were observed in the secondary outcomes.ConclusionsAdding a home-based exercise program with telemonitoring guidance following completion of a phase II ambulatory CR program results in further improvement of physical fitness and is equally as effective as prolonging a center-based CR in patients with CAD.Trial RegistrationClinicalTrials.gov NCT02047942; https://clinicaltrials.gov/ct2/show/NCT02047942 (Archived by WebCite at http://www.webcitation.org/70CBkSURj)

Highlights

Cardiovascular diseases (CVD) remain the leading contributor to global premature mortality and morbidity
Cardiac rehabilitation (CR) is recognized as an essential part of contemporary coronary artery disease (CAD) management that has significantly contributed to the observed reduction in cardiovascular mortality and disability by facilitating the adoption of and adherence to healthy behaviors and promoting an active lifestyle [3]
We report on the secondary objective of the TeleRehabilitation in Coronary Heart disease (TRiCH) study

Summary

Introduction

Cardiovascular diseases (CVD) remain the leading contributor to global premature mortality and morbidity. Secondary prevention of CVD, including coronary artery disease (CAD), by means of cardiac rehabilitation (CR) is considered a class IA recommendation by the European Society of Cardiology, American Heart Association, and American College of Cardiology [2]. CR is recognized as an essential part of contemporary CAD management that has significantly contributed to the observed reduction in cardiovascular mortality and disability by facilitating the adoption of and adherence to healthy behaviors and promoting an active lifestyle [3]. Studies have shown that patients exiting center-based CR have difficulty retaining the positive benefits derived from their participation [5]. Cardiac rehabilitation (CR) is an essential part of contemporary coronary heart disease management. Patients exiting a center-based CR program have difficulty retaining its benefits

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