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Digital Health Intervention as an Adjunct to Cardiac Rehabilitation Reduces Cardiovascular Risk Factors and Rehospitalizations

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Abstract

Cardiac rehabilitation (CR) following myocardial infarction is vastly underused. As such, the aim of this study was to test a digital health intervention (DHI) as an adjunct to CR. Patients undergoing standard Mayo Clinic CR were recruited prior to CR (n = 25) or after 3 months CR (n = 17). Changes in risk factors and rehospitalizations plus emergency department (ED) visits were assessed after 3 months. Patients assigned to DHI during CR had significant reductions in weight (−4.0 ± 5.2 kg, P = .001), blood pressure (−10.8 ± 13.5 mmHg, P = .0009), and the group using DHI after 3 months of CR had significant reductions in weight (−2.5 ± 3.8 kg, P = .04) and systolic BP (−12.6 ± 12.4 mmHg, P = .001) compared to the control groups. Both DHI groups also displayed significant reductions in rehospitalizations/ED visits (−37.9 %, P = 0.01 and −28 %, P = .04, respectively). This study suggests that a guideline-driven DHI CR program can augment secondary prevention strategies during usual CR by improving risk factors for repeat events.

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Acknowledgments

The authors thank the Binational Industrial Research and Development (BIRD) Foundation for their financial support. We also extend appreciation to Arturo Weschler, MD and Healarium Inc. an e-Health company, Dallas TX for their assistance in data de-identification and gathering. The sponsors and granting institutions had no impact on the results or preparation of the manuscript.

Compliance with Ethical Standards

ᅟ

Funding

This study was funded by Binational Industrial Research and Development (BIRD) Foundation #1303. This publication was also made possible by CTSA Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, 200 1st Street SW, Rochester, MN, 55905, USA

    R. Jay Widmer, Thomas G. Allison & Amir Lerman

  2. Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN, 55905, USA

    Lilach O. Lerman

Authors
  1. R. Jay Widmer
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  2. Thomas G. Allison
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  3. Lilach O. Lerman
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  4. Amir Lerman
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Corresponding author

Correspondence to Amir Lerman.

Additional information

Editor-in-Chief Jennifer L. Hall oversaw the review of this article

Statement on clinical relevance

This study demonstrates feasibility of a digital health initiative in cardiac rehabilitation, not only reducing cardiovascular risk factors but also demonstrating drastic reductions in clinically important outcomes such as rehospitalizations and emergency department visits over and above usual cardiac rehabilitation. This work should be used as a guide for future digital/mobile health studies in secondary CVD risk and event reduction.

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Widmer, R.J., Allison, T.G., Lerman, L.O. et al. Digital Health Intervention as an Adjunct to Cardiac Rehabilitation Reduces Cardiovascular Risk Factors and Rehospitalizations. J. of Cardiovasc. Trans. Res. 8, 283–292 (2015). https://doi.org/10.1007/s12265-015-9629-1

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