Nikki Gardiner Clinical Lead for Cardiac Pulmonary Rehabilitation

Nikki Gardiner Clinical Lead for Cardiac & Pulmonary Rehabilitation Leicester’s Research Live – celebrating our success

Activate Your Heart© web-based Cardiac Rehabilitation programme University Hospitals of Leicester NHS Trust Leicester’s Research Live – celebrating our success

Background • In an effort to improve our local uptake rate to Cardiac Rehabilitation (CR) and in response to patients expectations. • We designed a prototype website - part of this work was supported through a Shine innovation award from the Health Foundation. • Test the acceptability and effectiveness of a web based approach to CR as an alternative to our hospital based programme. Leicester’s Research Live – celebrating our success

Benefits. • 24/7 • Goal settings • Standardised reliable information • Structured • Open communication • Individualised programme • Easily integrated into clinical service • Track patient progress Leicester’s Research Live – celebrating our success

Individual Assessment • • • The usual measures of : Exercise capacity using the ISWT. Quality of Life. Anxiety & Depression. Risk factor measures were also recorded: Smoking status. Previous exercise habits. Diet & BMI. Blood pressure & heart rate/ECG. An activation code was then given to the patient to log into AYH CR programme

Stages of Activate Your Heart • Stage 1 - Exercise safety test • Stage 3 - Record in exercise diary 30 minutes continuous exercise for 5 days. Quiz • Stage 4 - Record in exercise diary 30 minutes continuous moderate exercise for 5 days. Minimum of 4 weeks • Stage 2 - Record in exercise diary – accumulative 30 minutes exercise for 5 days. Update goals

www. activateyourheart. org. uk

Knowledge Questionnaires • Questionnaire • Topics include: • • CHD Risk factors Medication Taken pre & post AYH

Knowledge Questionnaires Number of patients completed Pre questionnaire Number of patients Improved who completed both knowledge pre to pre and post questionnaires Same Worse 158 (100%) 139 (88%) 5 (3%) 12 (8%) 122 (77%)

Goal Setting • Automated goals generated from risk factor profile • Patients can create their own goals • Review and update goals

Goals Web patient average set goals = 6 Number of patients Total Goals fully number of completed goals/>50 % Goals completed equal to or more than 50% Goals No Goals completed less completed than 50% 158 138 (77%) 87 (55%) 13 (8%) 51 (32%) 7 (4%)

Notifications

Educational component

Email

Blog

Mobile Web • Easy access • Convenient • Access to all sections

Administration Features

Tracking patients

National Audit • ‘More should be done to support these options as part of the menu of approaches offered by programmes, as this can only help to improve uptake and adherence to CR. Web based options are presently being used by around 1% of patients and hopefully this approach will become more attractive’

Summary • The AYH Cardiac Rehabilitation programme is able to influence physical, psychosocial and behavioural changes in a low to moderate risk group of patients. • Increases patient choice • Tailored to the individual • Excellent patient feedback AYH • Increases capacity • Reduced waiting times • Helps to meet local & national targets include our local tariff for CR. • Releases CR professionals’ time for complex patients

Research Published research: • Evaluating the Interactive Web-Based Program, Activate Your Heart, for Cardiac Rehabilitation Patients: A Pilot Study. Brough C, Boyce S, Houchen-Wolloff L, Sewell L, Singh S. J Med Internet Res 2014; 16(10): e 242 URL: http: //www. jmir. org/2014/10/e 242/ doi: 10. 2196/jmir. 3027 • Exploring the experience of using a web-based cardiac rehabilitation programme in a primary care angina population: a qualitative study. Reena Devi, Christine Carpenter, John Powell, Sally Singh. International Journal of Therapy and Rehabilitation | Vol. 21 | No. 9 | pp 434– 440 • A Web-Based Program Improves Physical Activity Outcomes in a Primary Care Angina Population: Randomized Controlled Trial, Devi R, Powell J, Singh S; J Med Internet Res 2014; 16(9): e 186, URL: http: //www. jmir. org/2014/9/e 186, DOI: 10. 2196/jmir. 3340, PMID: 25217464, PMCID: 4180351 Current research: • A Web-Based Cardiac REhabilitatio. N Alternative for Those Declining or Dropping Out Of Conventional Rehabilitation: The WREN Feasibility Study. Two site blinded RCT. NIHR Rfp. B funded study.