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At home monitoring supports healthier hearts for Cambridgeshire patients during COVID-19 pandemic with Active+me REMOTE

Posted on September 14, 2020

Regular exercise is one of the best ways for people to make a good recovery following cardiac surgery or a heart attack, however in England only 50% of patients eligible for cardiac rehabilitation take up the service,1 which typically involves a mix of face-to-face exercise and education group classes.

The low engagement is attributed in part to inability to regularly attend appointments and an unwillingness to participate in face-to-face group classes. Furthermore, women are much less likely than men to take up cardiac rehabilitation, particularly within mixed white and asian ethnic groups.2 An additional challenge is ensuring that those patients who do engage continue with healthy habits into the future. As a result, the British Association for Cardiovascular Prevention and Rehabilitation highlights the importance of long-term management plans with strategies to encourage self-management and responsibility to pursue a healthy lifestyle, including regular exercise, a key priority.3

A potential solution to these issues is the use of a home-based monitoring system alongside standard cardiac rehabilitation. To explore if this would impact long-term adherence in cardiac rehabilitation services, Addenbrooke’s Hospital, supported by Eastern AHSN, initiated a pilot in September 2019, using Activ8rlives digital platform Active+me. 

Patients enrolled on the pilot are provided with standard cardiac rehabilitation care which includes guidance on safe exercise and education on risk factors and lifestyle changes, reinforced by educational resources on the Active+me programme. In addition, patients are provided with medical monitors to take home and record progress such as activity levels, blood pressure, weight and oxygen saturation. The data from which are uploaded to the App and shared securely with the hospital’s cardiac rehabilitation team.

One patient using the Active+me programme is Cambridgeshire-based Steve King. Steve enrolled onto the pilot in January 2020 after having a triple heart bypass in September 2019. He reflected:

“I had a heart attack in December 2014, which should have been a big wake up call for me but my heart attack was minor and looking back on it now I didn’t recognise I was particularly ill. So, I completed my cardiac rehabilitation and went back to work, without keeping up the exercise programme or making the changes I probably should have made to my diet and lifestyle. Subsequently I found myself needing a triple heart bypass five years later.”

“After my surgery I started my cardiac rehabilitation, but what was different this time was I enrolled onto the Active+me pilot which piqued my interest because of my research background. I also found out that I was borderline type 2 diabetic, which was further motivation to make a change to my lifestyle. Now I measure my weight, blood pressure and blood oxygen levels – all of which I didn’t pay any attention to before – as part of my daily routine. But what interests me most is the trends in my data over time, which I can monitor through the App.”

The data Steve collects is also shared with Addenbrooke’s Hospital to monitor his progress and address any concerns. For example, Steve recently received a call from Anna Sydes, Cardiac Rehabilitation Exercise Physiologist at Addenbrooke’s Hospital as she had noticed Steve’s blood pressure had been rising over several days. Steve recalled:

“On Anna’s advice I spoke to my GP and using the data from the Active+me app I was able to explain my change in blood pressure and the GP agreed to adjust my medication accordingly. It felt very reassuring that Anna and the team were looking out for me and it was empowering to have the data at hand to have an informed conversation with my GP.”

The Active+me pilot at Addenbrooke’s Hospital was well underway and then the COVID-19 pandemic caused all face-to-face cardiac rehabilitation appointments to be paused. So Addenbrooke’s Hospital, Aseptika (providers of the Active+me programme) and Eastern AHSN, with support from an Innovate UK grant, worked together to rapidly adapt to the Active+me REMOTE programme and ensure the same high-quality level of care could be delivered to Cambridgeshire patients from beginning to end without any face-to-face contact.

This approach can also empower patients to take charge of their recovery, with the added reassurance of the cardiac rehabilitation team remotely monitoring progress, identifying any concerns and supporting early intervention where necessary in the initial stages.

Steve’s cardiac rehabilitation was still ongoing at this point and he reflected:

“After the experience with my blood pressure rising, I decided I would commit to the group fitness classes in the next phase of my rehabilitation, but there was a waiting list for spaces. However, when COVID-19 caused all the fitness classes were to be moved onto Zoom, which the classes could accommodate more people, so I was able to join straightaway. That was a real benefit as I wanted to join the Zoom sessions while I was still motivated.”

“One of the things I’ve learnt through my cardiac rehabilitation this time is I’m not great at motivating myself. So, the online fitness classes have been great at holding me accountable and have given me the structure I needed.”

Steve concludes:

“I am really grateful I took part in the pilot; I feel much more self-aware, confident and in control of what I do now.”

–Ends–

References

1 British Heart Foundation., (2019). The National Audit of Cardiac Rehabilitation: quality and outcomes report 2019 [online]. British Heart Foundation. [Viewed 20th July 2020]. Available from: https://www.bhf.org.uk/informationsupport/publications/statistics/national-audit-of-cardiac-rehabilitation-quality-and-outcomes-report-2019

2 British Heart Foundation., (2018). The National Audit of Cardiac Rehabilitation: quality and outcomes report 2018 [online]. British Heart Foundation. [Viewed 20th July 2020]. Available from: https://www.bhf.org.uk/informationsupport/publications/statistics/national-audit-of-cardiac-rehabilitation-quality-and-outcomes-report-2018

3 British Association for Cardiovascular Prevention and Rehabilitation., (2017). The BACPR Standards and Core Components for Cardiovascular Disease Prevention and Rehabilitation [online]. [Viewed 31st July 2020]. Available from: http://www.bacpr.com/resources/6A7_BACR_Standards_and_Core_Components_2017.pdf    

Active+me REMOTE programme incorporating the six-pillars of self-care.
Active+me REMOTE programme incorporating the six-pillars of self-care.

 

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