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      Cardiac patients show high interest in technology enabled cardiovascular rehabilitation

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          Abstract

          Background

          Cardiac rehabilitation (CR) can slow or reverse the progression of cardiovascular disease (CVD). However, uptake of community-based CR is very low. E-cardiology, e-health and technology solutions for physical activity uptake and monitoring have evolved rapidly and have potential in CVD management. However, it is unclear what the current technology usage is of CVD patients, and their needs and interests for technology enabled CR.

          Methods

          A technology usage questionnaire was developed and completed by patients from a supervised ambulatory CR program and an adult congenital heart disease clinic and from two community-based CR programs. Results were described and related with age, gender and educational level by Spearman correlations.

          Results

          Of 310 patients, 298 patients (77 % male; mean age 61,7 ± 14,5 years) completed at least 25 questions of the survey and were included in the analysis (completion rate 96 %). Most (97 %) patients had a mobile phone and used the internet (91 %). Heart rate monitors were used by 35 % and 68 % reported to find heart rate monitoring important when exercising at home. Physical activity monitoring was reported by 12 % of the respondents. Respondents were interested in CR support through internet (77 %) and mobile phone (68 %). Many patients reported interest in game-based CR (67 %) and virtual rehabilitation (58 %). At least medium interest in technology enabled CR was reported by 75 % of the patients. Interest decreased with increasing age ( r = −0.16; p = 0.005).

          Conclusions

          CVD patients show interest for technology enabled home-based CR. Our results could guide the design of a technology-based, virtual CR intervention.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12911-016-0329-9) contains supplementary material, which is available to authorized users.

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          Most cited references28

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          Factors influencing acceptance of technology for aging in place: a systematic review.

          To provide an overview of factors influencing the acceptance of electronic technologies that support aging in place by community-dwelling older adults. Since technology acceptance factors fluctuate over time, a distinction was made between factors in the pre-implementation stage and factors in the post-implementation stage.
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            A systematic review of patient acceptance of consumer health information technology.

            A systematic literature review was performed to identify variables promoting consumer health information technology (CHIT) acceptance among patients. The electronic bibliographic databases Web of Science, Business Source Elite, CINAHL, Communication and Mass Media Complete, MEDLINE, PsycArticles, and PsycInfo were searched. A cited reference search of articles meeting the inclusion criteria was also conducted to reduce misses. Fifty-two articles met the selection criteria. Among them, 94 different variables were tested for associations with acceptance. Most of those tested (71%) were patient factors, including sociodemographic characteristics, health- and treatment-related variables, and prior experience or exposure to computer/health technology. Only ten variables were related to human-technology interaction; 16 were organizational factors; and one was related to the environment. In total, 62 (66%) were found to predict acceptance in at least one study. Existing literature focused largely on patient-related factors. No studies examined the impact of social and task factors on acceptance, and few tested the effects of organizational or environmental factors on acceptance. Future research guided by technology acceptance theories should fill those gaps to improve our understanding of patient CHIT acceptance, which in turn could lead to better CHIT design and implementation.
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              Alternative models of cardiac rehabilitation: a systematic review.

              The traditional hospital-based model of cardiac rehabilitation faces substantial challenges, such as cost and accessibility. These challenges have led to the development of alternative models of cardiac rehabilitation in recent years. The aim of this study was to identify and critique evidence for the effectiveness of these alternative models. A total of 22 databases were searched to identify quantitative studies or systematic reviews of quantitative studies regarding the effectiveness of alternative models of cardiac rehabilitation. Included studies were appraised using a Critical Appraisal Skills Programme tool and the National Health and Medical Research Council's designations for Level of Evidence. The 83 included articles described interventions in the following broad categories of alternative models of care: multifactorial individualized telehealth, internet based, telehealth focused on exercise, telehealth focused on recovery, community- or home-based, and complementary therapies. Multifactorial individualized telehealth and community- or home-based cardiac rehabilitation are effective alternative models of cardiac rehabilitation, as they have produced similar reductions in cardiovascular disease risk factors compared with hospital-based programmes. While further research is required to address the paucity of data available regarding the effectiveness of alternative models of cardiac rehabilitation in rural, remote, and culturally and linguistically diverse populations, our review indicates there is no need to rely on hospital-based strategies alone to deliver effective cardiac rehabilitation. Local healthcare systems should strive to integrate alternative models of cardiac rehabilitation, such as brief telehealth interventions tailored to individual's risk factor profiles as well as community- or home-based programmes, in order to ensure there are choices available for patients that best fit their needs, risk factor profile, and preferences.
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                Author and article information

                Contributors
                roselien.buys@kuleuven.be
                jomme.claes@kuleuven.be
                Deirdre.walsh@dcu.ie
                Nils.cornelis@student.kuleuven.be
                Kieran.moran@dcu.ie
                Werner.budts@uzleuven.be
                Catherine.woods@dcu.ie
                Veronique.cornelissen@kuleuven.be
                Journal
                BMC Med Inform Decis Mak
                BMC Med Inform Decis Mak
                BMC Medical Informatics and Decision Making
                BioMed Central (London )
                1472-6947
                19 July 2016
                19 July 2016
                2016
                : 16
                : 95
                Affiliations
                [ ]Department of Rehabilitation Sciences, University of Leuven, Herestraat 49, 3000 Leuven, Belgium
                [ ]Department of Cardiovascular Sciences, University of Leuven, Herestraat 49, 3000 Leuven, Belgium
                [ ]School of Health and Human Performance, Dublin City University, Dublin 9, Ireland
                [ ]Insight Centre for Data Analytics, Dublin City University, Dublin 9, Ireland
                [ ]Internal Medicine, Division of Cardiology, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium
                Author information
                http://orcid.org/0000-0001-8379-3971
                Article
                329
                10.1186/s12911-016-0329-9
                4949752
                27431419
                9df14fc8-3f27-4965-b1cc-461df69a7720
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 4 February 2016
                : 3 July 2016
                Funding
                Funded by: European Union’s Horizon 2020 Framework Programme for Research and Innovation Action
                Award ID: 643491
                Award Recipient :
                Funded by: FWO postdoctoral fellowship
                Funded by: FWO research grant
                Funded by: FWO research grant
                Funded by: Research grant from Fund for cardiac surgery
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Bioinformatics & Computational biology
                cardiac rehabilitation,technology,exercise,physical activity,lifestyle risk reduction

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