Abstract
BackgroundEmerging evidence indicates mobile technology–based strategies may improve access to secondary prevention and reduce risk factors in cardiac patients. However, little is known about cardiac patients’ use of mobile technology, particularly for health reasons and whether the usage varies across patient demographics.ObjectiveThis study aimed to describe cardiac patients’ use of mobile technology and to determine variations between age groups after adjusting for education, employment, and confidence with using mobile technology.MethodsCardiac patients eligible for attending cardiac rehabilitation were recruited from 9 hospital and community sites across metropolitan and rural settings in New South Wales, Australia. Participants completed a survey on the use of mobile technology devices, features used, confidence with using mobile technology, willingness and interest in learning, and health-related use.ResultsThe sample (N=282) had a mean age of 66.5 (standard deviation [SD] 10.6) years, 71.9% (203/282) were male, and 79.0% (223/282) lived in a metropolitan area. The most common diagnoses were percutaneous coronary intervention (33.3%, 94/282) and myocardial infarction (22.7%, 64/282). The majority (91.1%, 257/282) used at least one type of technology device, 70.9% (200/282) used mobile technology (mobile phone/tablet), and 31.9% (90/282) used all types. Technology was used by 54.6% (154/282) for health purposes, most often to access information on health conditions (41.4%, 117/282) and medications (34.8%, 98/282). Age had an important independent association with the use of mobile technology after adjusting for education, employment, and confidence. The youngest group (<56 years) was over 4 times more likely to use any mobile technology than the oldest (>69 years) age group (odds ratio [OR] 4.45, 95% CI 1.46-13.55), 5 times more likely to use mobile apps (OR 5.00, 95% CI 2.01-12.44), and 3 times more likely to use technology for health-related reasons (OR 3.31, 95% CI 1.34-8.18). Compared with the older group, the middle age group (56-69 years) was more than twice as likely to use any mobile technology (OR 2.42, 95% CI 1.27-4.59) and mobile technology for health-related purposes (OR 1.92, 95% CI 1.04-3.53). Participants who had completed high school were twice as likely to use mobile technology (OR 2.62, 95% CI 1.45-4.70), mobile apps (OR 2.05, 95% CI 1.09-3.84), and mobile technology for health-related reasons (OR 5.09, 95% CI 2.89-8.95) than those who had not completed high school. Associations were also present between participants living in metropolitan areas and mobile technology use (OR 1.07, 95% CI 1.07-4.24) and employment and mobile app use (OR 2.72, 95% CI 1.44-5.140).ConclusionsMobile technology offers an important opportunity to improve access to secondary prevention for cardiac patients, particularly when modified to suit subgroups. High levels of mobile technology use and health motivation need to be harnessed for secondary prevention.
Highlights
Cardiovascular disease (CVD) is a leading cause of death and disability globally [1]
This study identifies that the majority (54.6%, 154/282) of patients eligible for cardiac rehabilitation (CR) are using mobile technologies for health-related purposes [19], which was higher than reports from studies of general patient samples [16,21]
This study found that participants who had completed high school were at least five times more likely to be using mobile technology for health reasons than those not completing high school, which is consistent with a national survey on electronic health mobile health (mHealth) (eHealth) use in the United States [28]
Summary
Cardiovascular disease (CVD) is a leading cause of death and disability globally [1]. Recurrence of cardiac events is common, causing frequent hospitalizations and high costs to the health system [2]. An important evidence-based, cost-effective secondary prevention strategy is comprehensive cardiac rehabilitation (CR). Participation in CR reduces mortality and risk factors, as well as promotes recovery and quality of life [4,5]. A key factor contributing to poor CR participation is that delivery is in-person and offered at limited times and locations, so patients with limited resources, comorbidities, and other demands, such as caring roles, are unable to attend [7,8]. Technology, mobile devices that provide Internet access, offers a potential solution to reduce these barriers and improve access to secondary prevention strategies. Emerging evidence indicates mobile technology–based strategies may improve access to secondary prevention and reduce risk factors in cardiac patients. Little is known about cardiac patients’ use of mobile technology, for health reasons and whether the usage varies across patient demographics
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