A survey of digital access, digital confidence and rehabilitation delivery preferences of patients referred for CR

Helen Alexander; Andrew D'Silva; Christopher Tack; Aynsley Cowie

doi:10.5837/bjc.2023.031

A survey of digital access, digital confidence and rehabilitation delivery preferences of patients referred for CR

Br J Cardiol. 2023 Oct 10;30(4):31. doi: 10.5837/bjc.2023.031. eCollection 2023.

Authors

Helen Alexander¹, Andrew D'Silva², Christopher Tack³, Aynsley Cowie⁴

Affiliations

¹ Physiotherapy Manager and Rehabilitation Services Lead Nuffield Health at St. Bartholomew's Hospital, 38 Giltspur Street, London, EC1A 7BS.
² Consultant Cardiologist Guy's and St. Thomas' NHS Foundation Trust, St. Thomas' Hospital, Westminster Bridge Road, London, SE1 7EH.
³ Principal Consultant in Digital Health Channel 3 Consulting, 180 Borough High Street, London, SE1 1LB.
⁴ Consultant Physiotherapist Cardiac Rehabilitation and HARP, Lister Centre, University Hospital Crosshouse, NHS Ayrshire and Arran, KA2 0BE.

Abstract

Remote delivery of cardiovascular rehabilitation (CR) has been vital during the COVID pandemic when restrictions have been placed on face-to- face services. In the future, CR services are likely to offer alternatives to centre- based CR, including digital options. However, little is known about the digital access and confidence of CR service users, or their CR delivery preferences. A telephone survey was conducted of those referred for CR in the London boroughs of Lambeth and Southwark (n=60) in which questions were asked about digital access and confidence, as well as current and future delivery preferences for their CR. Between March and July 2021, 60 service-users met the inclusion criteria and were recruited for a telephone survey (mean age 60 ± 11.2 years). Of those, 82% had regular access to a smartphone, 60% to a computer or laptop and 43% to a tablet device. A high proportion of service users perceived themselves to be 'extremely' or 'somewhat' confident to use their devices. Thirty-nine (65%) service users would currently prefer a face-to- face assessment, rising to 82% once the perceived COVID-19 threat and restrictions are less. Preferences for accessing exercise were equally split between face-to-face and remotely supported independent exercise, with low interest in digital options. Delivery preferences for education, relaxation and peer support were more heterogeneous with interest in all delivery options. In conclusion, digital access and confidence in CR service users was good. Redesigning CR services to offer more rehabilitation delivery options, aligned with patient choice may increase uptake and further trials are needed to assess the impact.

Keywords: cardiac rehabilitation; digital; smart phone.

Grants and funding

Funding The authors are grateful for a grant from the Association of Chartered Physiotherapists in Cardiovascular Rehabilitation (ACPICR) project development fund which funded the main author to collect the survey data, and create a short report for dissemination to ACPICR members.