Aims: To evaluate the feasibility and effectiveness of an Integrated - Cardiac Rehabilitation programme Employing Smartphone Technology (I-CREST) for patients post-acute myocardial infarction (AMI) compared to a centre-based cardiac rehabilitation (CBCR) programme.
Methods: A two-arm parallel pilot randomized controlled trial was conducted with 50 post-AMI patients recruited from a tertiary hospital in Singapore. Participants were randomly allocated to either the I-CREST or the CBCR group. Data were collected at four time points: baseline, post-intervention (6 weeks), at 3 and 6 months. An intention-to-treat approach was adopted for data analysis.
Results: Out of 2,825 patients screened over 20 months, 171 (6.05%) were eligible, and 50 patients were enrolled. Pre-specified success criteria for feasibility were achieved regarding engagement, with a high rate of participation in weekly telephone calls (95.8%), and intervention safety was confirmed. However, the pre-specified success criteria for feasibility related to recruitment and engagement with weekly educational content were not met. In terms of effectiveness, I-CREST demonstrated significantly higher completion rates (84 vs. 40%; p = 0.001) and better 6-Minute Walk Test results at the 6-week time point (530.8 vs. 480.2 m; p = 0.017) compared to CBCR.
Conclusion: This pilot study demonstrated the feasibility of the I-CREST program, although recruitment methods require refinement. I-CREST showed promise as an effective alternative to CBCR, with fewer resources required. A full-scale study is recommended to confirm these findings statistically.
Trial registration: ClinicalTrials.gov: NCT05270993. https://clinicaltrials.gov/study/NCT05270993.
Keywords: Cardiac telerehabilitation; cardiac rehabilitation utilization; feasibility; mHealth; myocardial infarction.
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