MOTIVATE-CR+
Research type
Research Study
Full title
Mobile Health Biometrics to prescribe immediate remote physical activity for enhancing uptake to cardiac rehabilitation- MOTIVATE-CR+
IRAS ID
317494
Contact name
Helen Jones
Contact email
Sponsor organisation
Liverpool John Moores University
Clinicaltrials.gov Identifier
Duration of Study in the UK
2 years, 11 months, 31 days
Research summary
Research Summary
Cardiac rehabilitation is a programme of structured, supervised exercise that is prescribed to people with coronary heart disease (CHD) when they are discharged from hospital. It involves patients attending 1-2 sessions a week at a local hospital or community centre. The benefits of this programme are significant; it improves quality of life, reduces readmission to hospital and the risk of dying from cardiovascular disease. Despite these clear benefits, the uptake of cardiac rehabilitation is low, with only around half of those who are prescribed it attending their sessions. In many cases, there is also a significant delay between discharge from hospital and starting cardiac rehabilitation, which may well be contributing to limited uptake.
Professor Jones and her team aim to provide a bridging solution between hospital and supervised rehabilitation using mobile health technology (mhealth). This would allow people with CHD to start a home-based walking programme as soon as they are discharged from hospital. Using a combination of an app, smartphone and a wearable tracking device, individuals will be able to track their own exercise, whilst receiving advice and feedback from trained exercise professionals, without having to attend the hospital or a community centre. Participants will also be asked to measure their blood pressure, weight and how they are feeling in themselves. The study will involve two groups, one of which will receive standard care, and the other will receive this mhealth intervention. It will then be established whether this technology improves both uptake and overall wellbeing in patients.
Overall, this technology has the potential to improve the uptake of cardiac rehabilitation, aiding the NHS in its long term aim to increase uptake to 85% by 2028. This in turn could improve quality of life and overall outcome for patients with CHD. mhealth technology is a cost-effective and highly accessible form of healthcare which will ultimately allow services to reach those most in need within society who would have previously been allowed to fall through the gaps in care.
Summary of Results
Cardiac rehabilitation is a programme of structured, supervised exercise that is prescribed to people with coronary heart disease (CHD) when they are discharged from hospital. It involves patients attending 1-2 sessions a week at a local hospital or community centre. The benefits of this programme are significant; it improves quality of life, reduces readmission to hospital and the risk of dying from cardiovascular disease. Despite these clear benefits, the uptake of cardiac rehabilitation is low, with only around half of those who are prescribed it attending their sessions. In many cases, there is also a significant delay between discharge from hospital and starting cardiac rehabilitation, which may well be contributing to limited uptake.
This project aimed to provide a bridging solution between hospital and supervised rehabilitation using mobile health technology (mhealth). This allowed people with CHD to start a home-based walking programme as soon as they are discharged from hospital. Using a combination of an app, smartphone and a wearable tracking device, individuals were able to track their own exercise, whilst receiving advice and feedback from trained exercise professionals, without having to attend the hospital or a community centre. Participants were also asked to measure their blood pressure, weight and cholesterol levels and how they are felt both physically and mentally during that time. The study involved two groups, one of which received standard care, and the other received the mobile health intervention.We recruited 63 participants for the study split into 31 receiving the mHealth intervention and 32 who received traditional care (control group). We recruited the participants in line with our planned recruitment strategy and found that uptake of people into cardiac rehabilitation significantly increased using the mHealth technology (6 times more likely to attend CR) compared to the control group. We also found that those who used the mHealth devices were twice as likely to complete CR than the control group. Additionally, people with the mHealth support found that they were more active outside of the traditional exercise sessions and developed a habit of using the watch to monitor their activity levels and the intensity they did the exercise at, with 1 in 4 hitting national guidelines for physical activity every week (compared to 1 in 16 in control). Those patients receiving the behaviour counselling support also reported that they found those sessions motivating and felt that having someone monitoring them from afar made them more accountable.
In summary, the findings of this feasibility trial indicate the MOTIVATECR+ intervention is feasible and acceptable with promising effects on CR uptake, alongside adherence to purposeful exercise. This intervention, with the use of mHealth technology has the potential to improve the uptake of cardiac rehabilitation, aiding the NHS in its long term aim to increase uptake to 85% by 2028. This in turn could improve quality of life and overall outcome for patients with CHD.
REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
22/NW/0301
Date of REC Opinion
3 Oct 2022
REC opinion
Favourable Opinion