Issue 23-1, 2024

Original article

https://doi.org/10.38025/2078-1962-2024-23-1-56-65

Feasibility Study of Using the Integrated Telemedicine Platform “IS-cardio” for Outpatient Cardiological Rehabilitation: Single-Centered Cohort Study

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1 ORCID Elena V. Kotelnikova, 1 ORCID Vladimir I. Gridnev,1 ORCID Olga M. Posnenkova, 1 ORCID Valeriy N. Senchikhin

1V.I. Razumovsky Saratov State Medical University, Saratov, Russia


ABSTRACT

INTRODUCTION. The implementation of remote cardiac rehabilitation (RCR) technology based on telemedicine platforms (TMP) requires a preliminary assessment of the feasibility of use.

AIM. A preliminary study of the feasibility of using the integrated TMP “IS-cardio” to perform RCR in patients with cardiovascular diseases (CVD) in the context of need, feasibility and acceptability.

MATERIALS AND METHODS. Single-center cohort study of patients (n = 33; 75 % men; mean age 56 ± 8 years) with CVD. Testing of the TMP «IS-cardio» was carried out during 12-week physical training (PT) programs with an intensity of 55 %. Feasibility was assessed according to the following criteria: need, feasibility, acceptability. Data on need and acceptability were obtained from a patient survey. Feasibility was assessed as the proportion of patients completing RCR. Remote monitoring was performed using heart rate, blood pressure, electrocardiogram and mobile application recorders. Feedback was provided in the form of electronic reports and delayed consultation. Patient satisfaction was assessed in points.

RESULTS. 79.2 % of respondents were interested in telemedicine monitoring. 100 % of patients completed RCR; 12 patients (39.6 %) fully completed the PT program. The patients’ activity amounted to 2.4 ± 0.7 PT sessions per week; the average duration of PT was 56.5 ± 29.8 min/week. With a total satisfaction of 29.0 ± 3 points, the level of RCR was highly rated (3.85 ± 0.16 points) as a real solution to the problem associated with the presence of CVD (3.67 ± 0.34 points).

DISCUSSION. The medical-technological solution TMP “IS-cardio”, combining the principles of traditional cardiac rehabilitation with telecardiology tools (monitoring based on digital recorders, automatic data transfer and feedback) met the criteria for the feasibility of using TMP with a similar concept.

CONCLUSION. The high demand for remote monitoring, feasibility, and patient satisfaction of RCR may indicate the feasibility of its use for implementation of its programs.


KEYWORDS: remote cardiac rehabilitation, telemedicine platform, feasibility, cohort study

FUNDING: The study had no sponsorship.

CONFLICT OF INTEREST: The authors declare no apparent or potential conflicts of interest related to the publication of this article.

FOR CITATION:

Kotelnikova E.V., Gridnev V.I., Posnenkova O.M., Senchikhin V.N. Feasibility Study of Using the Integrated Telemedicine Platform “IS-cardio” for Outpatient Cardiological Rehabilitation: Single-Centered Cohort Study. Bulletin of Rehabilitation Medicine. 2024; 23(1):56-65. https://doi.org/10.38025/2078-1962-2024-23-1-56-65 (In Russ.)

ДЛЯ КОРРЕСПОНДЕНЦИИ:

Elena V. Kotelnikova, Е-mail: kotel_elena@mail.ru, meduniv@sgmu.ru


References:

  1. Bubnova M.G., Barbarash O.L., Doletsky A.A., et al. Acute ST elevation myocardial infarction: aftercare and secondary prevention. National Russian guidelines. Russian Journal of Cardiology. 2015; 1: 6–52. https://doi.org/10.15829/1560-4071-2015-1-6-52 (In Russ.).
  2. Bubnova M.G., Aronov D.M. Cardiorehabilitation: stages, principles and international classification of functioning (ICF). The Russian Journal of Preventive Medicine. 2020; 23(5): 40–9. https://doi.org/10.17116/profmed20202305140 (In Russ.).
  3. Hammill B.G., Curtis L.H., Schulman K.A., et al. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation. 2010; 121: 63–70. https://doi.org/10.1161/CIRCULATIONAHA.109.876383
  4. Sandesara P.B., Lambert C.T., Gordon N.F., et al. Cardiac rehabilitation and risk reduction: time to «rebrand and reinvigorate». Journal of The American College of Cardiology. 2015; 65(4): 389–95. https://doi.org/10.1016/j.jacc.2014.10.059
  5. Bubnova M.G. Actual problems of participation and education of cardiac patients in programs of cardiac rehabilitation and secondary prevention. Сardiovaskular Therapy and Prevention. 2020; 19(6): 2649. https://doi.org/10.15829/1728-8800-2020-2649 (In Russ.).
  6. Varma N., Cygankiewicz I., Turakhia M., et al. 2021 ISHNE/HRS/EHRA/APHRS collaborative statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals. International Journal of Environmental Research and Public Health. 2021; 2(1): 4–54. https://doi.org/10.1016/j.cvdhj.2020.11.004
  7. Aragaki D., Luo J., Weiner E., et al. Cardiopulmonary Telerehabilitation. Circulation: Arrhythmia and Electrophysiology. 2021; 32(2): 263–76. https://doi.org/10.1016/j.pmr.2021.01.004
  8. McDermott M.M., Spring B., Berger J.S., 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. Journal of the American Medical Association. 2018; 319(16): 1665–76. https://doi.org/10.1007/s11606-018-4621-5
  9. Piepoli M.F., Hoes A.W., Agewall S., et al. ESC Scientific Document Group. 2016 European guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). European Heart Journal. 2016; 37: 2315–81. https://doi.org/10.1093/eurheartj/ehw106
  10. Anderson L., Sharp G.A., Norton R.J., et al. Home-based versus centre-based cardiac rehabilitation. Cochrane Database of Systematic Reviews. 2017; 6: CD007130. https://doi.org/10.1002/14651858.CD007130
  11. Hannan A.L., Harders M.P., Hing W., et al. Impact of wearable physical activity monitoring devices with exercise prescription or advice in the maintenance phase of cardiac rehabilitation: systematic review and meta-analysis. BMC Sports Science, Medicine and Rehabilitation. 2019; 11: 14. https://doi.org/10.1186/s13102-019-0126-8
  12. Scherrenberg M., Wilhelm M., Hansen D., et al. The future is now: a call for action for cardiac telerehabilitation in the COVID-19 pandemic from the secondary prevention and rehabilitation section of the European Association of Preventive Cardiology. European Journal of Preventive Cardiology. 2020; 28(5): 524–40. https://doi.org/10.1177/2047487320939671
  13. Balady G.J., Ades P.A., Bittner V.A., et al. Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical сenters and beyond: a presidential advisory from the American Heart Association. Circulation. 2011; 124(25): 2951–60. https://doi.org/10.1161/CIR.0b013e31823b21e2
  14. Kirchhof P., Sipido K.R., Cowie M.R., et al. and ESC CRT R&D and European Affairs Work Shop on Personalized Medicine. The continuum of personalized cardiovascular medicine: a position paper of the European Society of Cardiology. European Heart Journal. 2014; 35(46): 3250–7. https://doi.org/10.1093/eurheartj/ehu312
  15. Abdrakhmanova G.I., Vasilkovskii S.A., Vishnevskii K.O., et al. Cifrovaya ekonomika: 2023: kratkij statisticheskij sbornik. Nats issled un-t Vysshaia shkola ekonomiki M.: NIU VSHE, 2023. 332 p. ISBN 978-5-7598-2697-2. (In Russ.).
  16. Wiegel J., Seppen B., van der Leeden M., et al. Adherence to Telemonitoring by Electronic Patient-Reported Outcome Measures in Patients with Chronic Diseases: A Systematic Review. International Journal of Environmental Research and Public Health. 2021; 18: 10161. https://doi.org/10.3390/ijerph181910161
  17. Dayer L., Heldenbrand S., Anderson S., et al. Smartphone medication adherence apps: Potential benefits to patients and providers. Journal of the American Pharmacists Association. 2013; 53(2): 172–81. https://doi.org/10.1331/JAPhA.2013.12202
  18. Deming E. Novaya paradigma upravleniya lyud’mi, sistemami i processami. M.: Alpina Pablisher, 2019. 417 р. (In Russ.).
  19. Constand M.K., MacDermid J.C., Dal Bello-Haas V., et al. Scoping review of patient-centered care approaches in healthcare. BMC Health Services Research. 2014; 14: 271. https://doi.org/10.1186/1472-6963-14-271
  20. Borg G. Psychophysical scaling with applications in physical work and the perception of exertion. Scandinavian Journal of Work, Environment & Health. 1990; 16(Suppl. 1): 55–8. https://doi.org/10.5271/sjweh.1815
  21. Lear S.A., Singer J., Banner-Lukaris D., et al. Randomized trial of a virtual cardiac rehabilitation program delivered at a distance via the internet. Circulation: Cardiovascular Quality and Outcomes. 2014; 7(6): 952–9. https://doi.org/10.1161/CIRCOUTCOMES.114.001230
  22. Bowen D.J., Kreuter M., Spring B., et al. How We Design Feasibility Studies. American Journal of Preventive Medicine. 2009; 36(5): 452–7. https://doi.org/10.1016/j.amepre.2009.02.002
  23. Attkisson C., Greenfield T.K. The UCSF client satisfaction scales: I. The Client Satisfaction Questionnaire-8. In: Maruish M., ed. The use of psychological testing for treatment planning and outcome assessment. Mahwah N.J.: Lawrence Erlbaum Associates; 2004: 799–811.
  24. World Health Organization 2016. Global diffusion of eHealth: making universal health coverage achievable. Report of the third global survey on eHealth. December 15, 2016. Available at: https://www.who.int/publications/i/item/9789241511780 (Accessed January 12, 2024).
  25. Otchet «Digital 2022 Russian Federation» — Cifrovye tendencii v Rossii v 2022 godu. Available at: https://cpa.rip/stati/digital-2022-russian-federation/ (Accessed November 16, 2023). (In Russ.).
  26. Zhelezniakova I.A., Khelisupali T.A., Omelianovskii V.V., et al. Analysis of the possibility of applying foreign experience in the provision of telemedicine services in the Russian Federation. Medical Technologies. Assessment and Choice. 2020; 2: 26–34. https://doi.org/10.17116/medtech20204002126 (In Russ.).
  27. Medvedeva E.I., Aleksandrova O.A., Kroshilin S.V. Telemedicine in modern conditions: The attitude of society and the vector of development. Economic and Social Changes: Facts, Trends, Forecast. 2022; 15(3): 200–22. https://doi.org/10.15838/esc.2022.3.81.11 (In Russ.).
  28. Kikuchi A., Taniguchi T., Nakamoto K., et al. Feasibility of home-based cardiac rehabilitation using an integrated telerehabilitation platform in elderly patients with heart failure: A pilot study. Journal of Cardiology. 2021; 78(1): 66–71. https://doi.org/10.1016/j.jjcc.2021.01.010
  29. Batalik L., Filakova K., Batalikova K., et al. Remotely monitored telerehabilitation for cardiac patients: A review of the current situation. World Journal of Clinical Cases. 2020; 8(10): 1818–31. https://doi.org/10.12998/wjcc.v8.i10.1818
  30. Ritchey M.D., Maresh S., McNeely J., et al. Tracking cardiac rehabilitation participation and completion among medicare beneficiaries to inform the efforts of a national initiative. Circulation: Cardiovascular Quality and Outcomes. 2020; 13: e005902 https://doi.org/10.1161/CIRCOUTCOMES.119.005902
  31. Mays J.A., Mathias P.C. Measuring the rate of manual transcription error in outpatient point-of-care testing. Journal of the American Medical Informatics Association: JAMIA. 2019; 26(3): 269–72. https://doi.org/10.1093/jamia/ocy170
  32. Pokida A.N., Zybunovskaia N.V. The development of telemedicine in Russia: the view of consumers. Public Health and Life Environment 2021; 29(12): 7–16. https://doi.org/10.35627/2219-5238/2021-29-12-7-16 (In Russ.).
  33. Nishitani-Yokoyama M., Shimada K., Fujiwara K., et al. Safety and Feasibility of Tele-Cardiac Rehabilitation Using Remote Biological Signal Monitoring System: A Pilot Study. Cardiology Research. 2023; 14(4): 261–7. https://doi.org/10.14740 %2Fcr1530



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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.