Samenvatting
Background: Cardiac rehabilitation in patients with chronic heart failure (CHF) has favourable effects on exercise capacity, the risk at hospital (re-)admission and quality of life. Although cardiac rehabilitation is generally recommended it is still under-utilised in daily clinical practice, particularly in frail elderly patients after hospital admission, mainly due to low referral and patient-related barriers. Cardiac telerehabilitation (CTR) has the potential to partially solve these barriers. The purpose of this study is to evaluate the effects of CTR as compared to standard remote care after hospital admission on physical functional capacity in CHF patients. Methods: In this randomised controlled trial, 64 CHF patients will be recruited during hospitalisation for acute decompensated heart failure, and randomised to CTR combined with remote patient management (RPM) or RPM alone (1:1). All participants will start with RPM after hospital discharge for early detection of deterioration, and will be up titrated to optimal medical therapy before being randomised. CTR will start after randomisation and consists of an 18-week multidisciplinary programme with exercise training by physical and occupational therapists, supported by a (remote) technology-assisted dietary intervention and mental health guiding by a physiologist. The training programme consists of three centre-based and two home-based video exercise training sessions followed by weekly video coaching. The mental health and dietary programme are executed using individual and group video sessions. A wrist-worn device enables remote coaching by the physical therapist. The web application is used for promoting self-management by the following modules: 1) goal setting, 2) progress tracking, 3) education, and 4) video and chat communication. The primary outcome measure is physical functional capacity evaluated by the Short Physical Performance Battery (SPPB) score. Secondary outcome measures include frailty scoring, recovery after submaximal exercise, subjective health status, compliance and acceptance to the rehabilitation programme, and readmission rate. Discussion: The Tele-ADHF trial is the first prospective randomised controlled trial designed for evaluating the effects of a comprehensive combined RPM and CTR programme in recently hospitalised CHF patients. We hypothesize that this intervention has superior effects on physical functional capacity than RPM alone. Trial registration: Netherlands Trial Registry (NTR) NL9619, registered 21 July 2021.
| Originele taal-2 | Engels |
|---|---|
| Artikelnummer | 379 |
| Tijdschrift | BMC Cardiovascular Disorders |
| Volume | 23 |
| Nummer van het tijdschrift | 1 |
| DOI's | |
| Status | Gepubliceerd - dec. 2023 |
Bibliografische nota
Funding Information:This study is funded by the Dutch consortium for Knowledge and Innovation (TKI) High Tech Systems and Materials. The Maxima Medical Centre and the Catharina Hospital fund the deployment of medical professionals, the use of examination rooms and equipment, and the performance of laboratory tests during the study period. Philips Electronics Nederland B.V. provides the wrist-worn devices (PHB) during the study period. Roche Diagnostics International Ltd, Switzerland, funds products for determining GDF15 used by the laboratory of the Catharina Hospital Eindhoven. The funding sources had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data, or decision to submit results.
Publisher Copyright:
© 2023, The Author(s).
Financiering
This study is funded by the Dutch consortium for Knowledge and Innovation (TKI) High Tech Systems and Materials. The Maxima Medical Centre and the Catharina Hospital fund the deployment of medical professionals, the use of examination rooms and equipment, and the performance of laboratory tests during the study period. Philips Electronics Nederland B.V. provides the wrist-worn devices (PHB) during the study period. Roche Diagnostics International Ltd, Switzerland, funds products for determining GDF15 used by the laboratory of the Catharina Hospital Eindhoven. The funding sources had no role in the design of this study and will not have any role during its execution, analyses, interpretation of the data, or decision to submit results.
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