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Effect of a lifestyle-focused electronic patient support application for improving risk factor management, self-rated health, and prognosis in post-myocardial infarction patients: study protocol for a multi-center randomized controlled trial
Umea Univ, Sweden; Umea Univ, Sweden; Commonwealth Sci Res and Ind Org CSIRO, Australia.
Lund Univ, Sweden; Skane Univ Hosp, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Sahlgrens Univ Hosp, Sweden.
Lund Univ, Sweden; Skane Univ Hosp, Sweden.
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2019 (English)In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, article id 76Article in journal (Refereed) Published
Abstract [en]

BackgroundCardiac rehabilitation (CR) programs addressing risk factor management, educational interventions, and exercise contribute to reduce mortality after myocardial infarction (MI). However, the fulfillment of guideline-recommended CR targets is currently unsatisfactory. eHealth, i.e., the use of electronic communication for healthcare, including the use of mobile smartphone applications combined with different sensors and interactive computerized programs, offers a new array of possibilities to provide clinical care. The present study aims to assess the efficacy of a web-based application (app) designed to support persons in adhering to lifestyle advice and medication as a complement to traditional CR programs for improvement of risk factors and clinical outcomes in patients with MI compared with usual care.Methods/designAn open-label multi-center randomized controlled trial is being conducted at different CR centers from three Swedish University Hospitals. The aim is to include 150 patients with MI amp;lt;75years of age who are confident smartphone and/or Internet users. In addition to participation in CR programs according to the usual routine at each center, patients randomized to the intervention arm will receive access to the web-based app. A CR nurse reviews the patients self-reported data twice weekly through a medical interface at the clinic. The primary outcome of the study will be change in submaximal exercise capacity (in watts) between 2 and 4weeks after discharge and when the patient has completed his/her exercise program at the CR center, usually around 3-6months post-discharge. Secondary outcomes include changes in self-reported physical activity, objectively assessed physical activity by accelerometry, self-rated health, dietary, and smoking habits, body mass index, blood pressure, blood lipids, and glucose/HbA1c levels between inclusion and follow-up visits during the first year post-MI. Additionally, we will assess uptake and adherence to the application, the number of CR staff contacts, and the incidence of cardiovascular events at 1 and 3 years after the MI. Patient recruitment started in 2016, and the first study results are expected in the beginning of 2019.DiscussionThe present study will add evidence to whether electronic communication can be used to improve traditional CR programs for patients after MI.Trial registrationClinicalTrials.gov, NCT03260582. Retrospectively registered on 24 August 2017.

Place, publisher, year, edition, pages
BMC , 2019. Vol. 20, article id 76
Keywords [en]
eHealth; Myocardial infarction; Cardiac rehabilitation; Web-based application; Smartphone application; Cardiovascular; Risk factors; Prognosis; Quality of life
National Category
Physiotherapy
Identifiers
URN: urn:nbn:se:liu:diva-154690DOI: 10.1186/s13063-018-3118-1ISI: 000457237000001PubMedID: 30678709OAI: oai:DiVA.org:liu-154690DiVA, id: diva2:1292646
Note

Funding Agencies|Faculty of Medicine at Lund University; Department of Coronary Care at Skane University Hospital "Centre of Excellence in Skane" Funds; Cross Technology Solutions; ALF Grants County Council of Vasterbotten

Available from: 2019-02-28 Created: 2019-02-28 Last updated: 2019-03-15

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