The changing face of cardiac rehab: How health technology has improved the way cardiac patients access vital rehabilitation services
Aseptika, a Cambridge-based healthcare business, has developed an innovative remote monitoring system for cardiac rehabilitation patients. This system has been awarded a “Highly Commended” in the Selfcare Forum awards for 2020.
The system, called Active⁺me REMOTE Cardiac Recovery, is a cardiac recovery service delivered remotely in partnership with cardiac rehabilitation centres. During the Covid-19 enforced lockdown earlier this year, a pilot of the Active⁺me REMOTE service at Addenbrooke’s Hospital in Cambridge quickly adapted to help patients keep up their exercise and manage their recovery thanks to funding from Innovate UK and support from Eastern AHSN.
This generated valuable data for the service, but it was not until Aseptika was accepted onto the Wellbeing Accelerator programme at Sheffield Hallam University’s Advanced Wellbeing Research Centre (AWRC) that the true value of this data could be realised.
The AWRC Wellbeing Accelerator, with support from the Yorkshire and Humber AHSN (YH AHSN), has funded an independent analysis of the data that was conducted by an AWRC senior research fellow, Dr Simon Nichols.
Every year the Self Care Forum awards prizes and commendations for exemplary self-care innovation during Self-Care Week. Self-Care Week, which this year is between 16-22 November, is an annual national awareness week that focuses on embedding support for self-care across communities, families and generations. This year, the Self Care Forum awards will also celebrate good self-care practice for coronavirus initiatives.
Active⁺me empowers patients to take charge of their own recovery, providing them 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 REMOTE Recovery platform. 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 an app and shared securely with the hospital’s cardiac rehabilitation team.
Despite the challenge of implementing a pilot during the pandemic, the commitment and focus of all partners to adapt and deliver the programme has led to the successful rollout of the Active⁺me REMOTE Cardiac Recovery service.
Dr Nichols said, “our evaluation of the Addenbrooke’s data found participating in cardiac rehabilitation, facilitated using the Active⁺me REMOTE system, was associated with an increase in Patient Activation Measure scores. The Patient Activation Measure is a tool used to assess patient knowledge of, and confidence in, managing their health condition.
“There were also reductions in systolic blood pressure, waist circumference, and an increase in self-reported physical activity levels. These findings are significant in supporting Commissioner decision making regarding how cardiac rehab services are provided throughout the upcoming lockdown and beyond”.
Kevin Auton, founder of Aseptika, said “this highly commended award is a ringing endorsement of the benefits of our Active⁺me REMOTE Recovery service for patients and the benefits of a great team of collaborators. Without the great work and support of the teams at the AWRC, Addenbrookes, YH AHSN and Eastern AHSN none of this would have been possible”.
The Active⁺me REMOTE Cardiac Recovery programme incorporates the use by patients of Blood Pressure Monitor, Pulse Oximeter, Activity Tracker and Body Analyser, linked by Bluetooth to their smart device. One patient using the Active⁺me REMOTE platform 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.”
Steve found the changes brought about in response to the coronavirus pandemic were in fact more beneficial to his rehabilitation:
“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 to be moved onto Zoom the classes could accommodate more people, so I was able to join straightaway. That was a real benefit as I wanted to join the 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”.
“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”.
Cardiac Rehabilitation Facts
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.
Women are much less likely than men to take up cardiac rehabilitation, particularly within mixed white and Asian ethnic groups. (2)
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)
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 here.
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 here.
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 here.
For a full list of the winning and highly commended entries of the Self Care Coronavirus Innovation Awards visit https://www.selfcareforum.org/2020/06/11/coronavirus-innovations-award/#Case_study_%E2%80%93_Addenbrookes_Hospital,_Cambridge_University_Hospital,_EAHSN_and_Aseptika_Ltd
Impact on Cardiac Rehabilitation of using Aseptika’s Active+me REMOTE during the Pandemic Published. Read the results of Active+me REMOTE delivered at Addenbrooke's Hospital, Cambridge. Avaliable here.