Digital cardiac rehab almost halves hospital readmissions: Study

The world has changed in many ways since the first iPhone was launched in 2007, but one unexpected positive has been the product’s impact on heart health.
 
From apps, to SMS, and video conferencing, the growth of smartphones has given rise to a myriad of digital health programs, the impacts of which are now being realised.  
 
According to new research from the Baker Heart and Diabetes Institute, digital cardiac rehabilitation programs can now substantially reduce a person’s chance of being readmitted to hospital with heart disease, compared to face-to-face programs alone.
 
‘Rather than replacing the entire traditional model of care with a digital solution, digitally integrated models may provide disease management strategies in a more engaging, accessible, and scalable manner,’ the study concluded.
 
Researchers analysed 18 global studies of digital health programs involving mobile apps, SMS, remoting monitoring or video or phone conferencing.
 
The studies dated back to 2007, to coincide with the release of the Apple iPhone, the first internet-accessible smartphone with apps.
 
The findings revealed there was a 32% reduction in the relative risk of re-hospitalisation for any cause in people who utilised a mobile health Disease Management Program compared to a traditional program.
 
There was also a 45% relative risk reduction in cardiovascular-related re-hospitalisations.
 
However, there was no significant reduction for mortality outcomes or major adverse cardiovascular events.

Those findings come as just one third of Australians participate in rehabilitation after suffering an acute heart attack.
 
RACGP Expert Committee – Practice and Technology Management Chair Dr Rob Hosking told newsGP while digital programs represent a positive step forward, they should not completely replace traditional rehabilitation systems.
 
‘There are very many people who are in an age group who can’t use the digital system, but if it complements the existing in-person cardiac rehab programs then that’s great,’ he said.
 
‘The problem is a lot of the people who need the services can’t use digital systems, they’re unable, or incapable, or they have limited access to adequate bandwidth.
 
‘If they’re using a system, the GP needs to be aware of what the system is, what it does, and how it can help.’
 
Australians living with heart disease are up to seven times more likely to suffer future heart events than those without heart disease.
 
Currently, most disease management programs include heart health education, care coordination, exercise prescription, medication management and adherence, self-monitoring strategies, psychosocial support, behaviour change and goal setting.
 
The paper’s senior author, Associate Professor Melinda Carrington, said digital health programs are providing patients with choice, access, and control of their care.
 
‘We need to look at more modern day, alternative delivery methods of cardiac rehabilitation to increase access and engagement to improve the quality of life for people with heart disease and to reduce preventable and costly re-admissions to hospital,’ she said.
 
‘For governments and policy makers, there is also a strong message about cost efficiencies when it comes to healthcare delivery by reducing clinician and health system burden.’
 
Four million Australians are currently living with cardiovascular disease, around 16.6% of the total population, with the condition accounting for one quarter of all deaths each year.
 
Additionally, heart attack sufferers are twice as likely to die prematurely compared to the general population.
 
But Dr Hosking said GPs are often forgotten when it comes to heart rehabilitation and management, with many patients referred to a hospital for their follow-up care. 
 
‘GPs could support patients if they involved us. We can be involved in how to encourage them, how to train up our practice nurses so they can be involved,’ he said.
 
‘Promotion of activity is what’s involved in cardiac rehab, usually staged increasing of activity levels and regaining confidence that they can do things without damaging their heart, and if that can be done locally, that’s obviously better than people travelling along the way.
 
‘These digital systems could be useful for people in rural and regional areas … it’s a good thing, but it shouldn’t replace existing face-to-face care, and it also would be ideal if GPs were involved in what the plans were and how to support that digital system.’
 
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cardiology cardiovascular disease heart attack heart failure