Digitally integrated models show impressive outcomes in heart disease

Digital & Innovation: Digital cardiac rehabilitation programs have emerged as a game-changer in the realm of heart disease management. These programs have displayed a remarkable ability to significantly reduce the likelihood of hospital readmissions when compared to traditional face to face programs, according to a systematic review and meta-analysis by the Baker Heart and Diabetes Institute.

The findings of 18 global studies, including those conducted in Australia, underscore the impact of digital health programs, which leverage tools such as mobile applications, SMS communication, remote monitoring, and video or phone conferencing. These digital interventions have proven to be exceptionally effective in reducing hospital readmissions and emergency department visits for individuals grappling with heart diseases, including those who have previously experienced heart attacks.

Merely 37% of Australians participate in cardiac rehabilitation following an acute cardiac event. This alarming statistic emphasises the urgent need for novel approaches to delivering disease management programs, offering a lifeline to these high-risk patients who face heart-related events or complications.

The study’s findings are impressive: a 32% reduction in the relative risk of re-hospitalisation for any cause and a 45% relative risk reduction in cardiovascular-related re-hospitalisations among those who embraced mobile health Disease Management Programs compared to their counterparts in traditional programs.

According to Justin Braver, a PhD candidate at the Baker Institute and co-author of the study, what distinguished these digitally-enabled cardiac rehabilitation programs from traditional ones is their unparalleled ability to reach a broader spectrum of patients, empowering them to complete their rehabilitation at their convenience, be it in terms of time or location.

However, the study refrained from pinpointing a single component responsible for these remarkable results. Instead, it suggests that a synergy of factors is at play which is boosting patient education, enhancing communication with healthcare professionals, and fostering greater patient engagement.

Associate Professor Melinda Carrington, senior author and Head of Preclinical Disease and Prevention, Baker Heart and Diabetes Institute, elaborated “The top line message is to participate in a cardiac rehabilitation program, in whatever form suits you and is available to you, because we know that there is significant evidence showing that it is effective.

“About 4.2 million Australians are living with a cardiovascular condition, and of those, 1.2 million have been diagnosed with heart disease and are 5 to 7 times more likely to suffer future heart events than those without heart disease,” she explained.

Disease Management Programs, as the study highlights, are a comprehensive framework for delivering care to cardiac disease patients. Typically coordinated by nurses in collaboration with healthcare professionals, these programs encompass heart health education, care coordination, exercise prescriptions, medication management, self-monitoring strategies, psychosocial support, behaviour change, and goal setting.

In light of these statistics, modern and alternative delivery methods for cardiac rehabilitation become imperative to improve the quality of life for heart disease patients while concurrently mitigating the burden of preventable and costly hospital readmissions.

Associate Professor Carrington emphasised “For governments and policy makers, there is also a strong message about cost efficiencies when it comes to healthcare delivery by reducing clinician and health system burden.

“Rather than replace the entire traditional model of care which has a proven track record of success for a digital solution, digitally integrated models may provide disease management strategies in a more engaging, accessible and scalable manner.”

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