Possibilities of Managing Cardiovascular Risk Factors in Telemedicine Programs for Cardiac Rehabilitation
https://doi.org/10.31550/1727-2378-2022-21-6-6-12
Abstract
Study Objective: To study the possibilities of correcting modifiable cardiovascular risk factors (FCR) and patient satisfaction according to the results of a 12-month program of telemedicine cardiorehabilitation (TMCR).
Study Design: Prospective comparative study.
Materials and Methods. The TMCR program was completed by 28 patients (of which 85.7% were men; age — 55.2 ± 10.7 years) with ischemic heart disease and/or arterial hypertension (AH) of the 1st–3rd degree, without cognitive dysfunction and contraindications to rehabilitation. The control group consisted of 30 patients (of which 80% were men; age 64.7 ± 6.9 years) who were under traditional observation. TMCR included office and remote consultations, mobile monitoring, the use of a mobile application and the Patient's Diary. The dynamics of modifiable FCR (physical activity, hypertension, smoking, obesity, dyslipidemia, diabetes mellitus) and satisfaction of patients with TMCR were assessed.
Study Results. After completion of TMCR, there was a decrease in systolic blood pressure (SBP) from 144 ± 15 to 130 ± 16 mm Hg (p = 0.02), diastolic blood pressure (DBP) — from 83.6 ± 11.2 to 73.3 ± 11.3 mm Hg (p = 0.03), total cholesterol level from 5.3 ± 1.3 mmol/l to 4.0 ± 1.0 mmol/l (p = 0.02), low-density lipoprotein cholesterol — from 2, 77 ± 0.9 to 1.9 ± 0.9 mmol/l (p = 0.04), triglycerides — from 1.61 ± 0.28 to 1.33 ± 0.61 mmol/l (p = 0,01) with high patient satisfaction with telemedicine care (20.9 ± 11.2 points).
Conclusion. High user readiness and patient satisfaction with telemedicine care are important factors in the practical implementation of modern CR technologies.
About the Authors
E. V. Kotelnikova
Federal State Budgetary Educational Institution of Higher Education “Saratov State Medical University named after V.I. Razumovsky” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
112 Bolshaya Kazachia Str., Saratov, Russian Federation 410012
V. N. Senchikhin
Federal State Budgetary Educational Institution of Higher Education “Saratov State Medical University named after V.I. Razumovsky” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
112 Bolshaya Kazachia Str., Saratov, Russian Federation 410012
T. P. Lipchanskaya
Federal State Budgetary Educational Institution of Higher Education “Saratov State Medical University named after V.I. Razumovsky” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
112 Bolshaya Kazachia Str., Saratov, Russian Federation 410012
O. E. Tsareva
Federal State Budgetary Educational Institution of Higher Education “Saratov State Medical University named after V.I. Razumovsky” of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
112 Bolshaya Kazachia Str., Saratov, Russian Federation 410012
References
1. Piepoli M.F., Corrà U., Adamopoulos S., Benzer W. et al. Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology. Eur. J. Prev. Cardiol. 2014; 21(6): 664–81. DOI: 10.1177/2047487312449597
2. Xu L., Li F., Zhou C., Li J. et al. The effect of mobile applications for improving adherence in cardiac rehabilitation: a systematic review and meta-analysis. BMC Cardiovasc. Disord. 2019; 19: 166. DOI: 10.1186/s12872-019-1149-5
3. Resurrección D.M., Moreno-Peral P., Gómez-Herranz M., Rubio-Valera M. et al. Factors associated with non-participation in and dropout from cardiac rehabilitation programmes: a systematic review of prospective cohort studies. Eur. J. Cardiovasc. Nurs. 2019; 18(1): 38–47. DOI: 10.1177/1474515118783157
4. Winnige P., Vysoky R., Dosbaba F., Batalik L. Cardiac rehabilitation and its essential role in the secondary prevention of cardiovascular diseases. World J. Clin. Cases. 2021; 9(8): 1761–84. DOI: 10.12998/wjcc.v9.i8.1761
5. Martinez K., Rood M.N., Jhangiani N., Lei Kou M.A. et al. Patterns of use and correlates of patient satisfaction with a large nationwide direct to consumer telemedicine service. J. Gen. Intern. Med. 2018; 33: 1768–73. DOI: 10.1007/s11606-018-4621-5
6. Persell S.D., Peprah Y.A., Lipiszko A.P., Lee J.Y. et al. Effect of home blood pressure monitoring via a smartphone hypertension coaching application or tracking application on adults with uncontrolled hypertension. A randomized clinical trial. JAMA Netw. Open. 2020; 3(3): e200255. DOI: 10.1001/jamanetworkopen.2020.0255
7. McDermott M.M., Spring B., Berger J.S., Treat-Jacobson D. et al. Effect of a home-based exercise intervention of wearable technology and telephone coaching on walking performance in peripheral artery disease: the HONOR randomized clinical trial. JAMA. 2018; 319(16): 1665-76. DOI: 10.1001/jama.2018.3275
8. Thomas R.J., Beatty A.L., Beckie T.M., Brewer L.C. et al. Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Circulation. 2019; 140: e69–89. DOI: 10.1161/ CIR.0000000000000663
9. Claes J., Buys R., Budts W., Smart N. et al. Longer-term effects of home-based exercise interventions on exercise capacity and physical activity in coronary artery disease patients: a systematic review and meta-analysis. Eur. J. Prev. Cardiol. 2017; 24(3): 244-56. DOI: 10.1177/2047487316675823
10. Marvel F.A., Spaulding E.M., Lee M.A., Yang W.E. et al. Digital health intervention in acute myocardial infarction. Circ. Cardiovasc. Qual. Outcomes. 2021; 14(7): e007741. DOI: 10.1161/CIRCOUTCOMES.121.007741
11. Tang L.H., Kikkenborg Berg S., Christensen J., Taylor R.S. et al. Patients' preference for exercise setting and its influence on the health benefits gained from exercise-based cardiac rehabilitation. Int. J. Cardiol. 2017; 232: 33–9. DOI: 10.1016/j.ijcard.2017.01.126
12. Balady G.J., Ades P.A., Bittner V.A., Franklin B.A. et al. Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical enters and beyond: a presidential advisory from the American Heart Association. Circulation. 2011; 124(25): 2951–60. DOI: 10.1161/CIR.0b013e31823b21e2
13. Riegel B., Moser D.K., Buck H.G., Dickson V.V. et al. Self-care for the prevention and management of cardiovascular disease and stroke. A scientific statement for healthcare professionals from the American Heart Association. J. Am. Heart Assoc. 2017; 6(9): e006997. DOI: 10.1161/JAHA.117.006997
14. Rawstorn J.C., Gant N., Direito A., Beckmann C. et al. Telehealth exercisebased cardiac rehabilitation: a systematic review and meta-analysis. Heart. 2016; 102(15): 1183–92. DOI: 10.1136/heartjnl-2015-308966
15. Peters A.E., Keeley E.C. Trends and predictors of participation in cardiac rehabilitation following acute myocardial infarction: data from the behavioral risk factor surveillance system. J. Am. Heart Assoc. 2017; 7: e007664. DOI: 10.1161/JAHA.117.007664
16. Battineni G., Sagaro G.G., Chintalapudi N., Amenta F. The benefits of telemedicine in personalized prevention of cardiovascular diseases (CVD): a systematic review. J. Pers. Med. 2021; 11(7): 658. DOI: 10.3390/jpm11070658
17. Belova A.N. Scales, tests and questionnaires in medical rehabilitation. A guide for doctors and researchers. M.: Antidor; 2004. 432 p. (in Russian)
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For citations:
Kotelnikova E.V., Senchikhin V.N., Lipchanskaya T.P., Tsareva O.E. Possibilities of Managing Cardiovascular Risk Factors in Telemedicine Programs for Cardiac Rehabilitation. Title. 2022;21(6):6-12. (In Russ.) https://doi.org/10.31550/1727-2378-2022-21-6-6-12
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