According to an as-yet unpublished study, the Mayo Clinic has found that incorporating a smartphone app into cardiac rehabilitation can reduce emergency room visits and hospital readmissions by 40 percent.
"The takeaway is that digital health, mobile health, can be used for cardiovascular disease prevention, especially in a high risk group," lead researcher Dr. R. Jay Widmer told MobiHealthNews. "But the success of an intervention does depend on the use and the amount of use. This is something that can be used to reduce disease burden across the healthcare system at times when paying for value is going to be at a premium."
In the study, which was funded by the BIRD Foundation and recently presented at the American College of Cardiology’s 63rd Annual Scientific Session in Washington, D.C., the Mayo Clinic designed an online and smartphone-based program for patients recovering from stent placement for a heart attack. Forty-four patients participated in the study -- 25 used the application and a control group of 19 had regular cardiac rehabilitation without the app.
Patients used the app for three months, and it had two functions: tracking patient vital signs and providing educational content. For the former, patients tracked weight, blood pressure, blood sugar, physical activity and dietary levels. The educational content was aimed at showing patients things they could do to help them avoid a secondary heart event, such as eating more fish or adding exercise into their daily routine.
"The application is really set up as a patient-centered self-monitoring system," Widmer said. "We ask the patients when they first log in to insert all of their own metrics so when they start cardiac rehab, they input their own blood pressure, weight, glucose, minutes of physical activity, and their diet so they can get a good idea of where they stand with cardiac disease prevention. Then the patient can log in either on a day-to-day or every other day basis and they are asked to again log some of those numbers, as well as perform a few educational tasks."
Around 60 percent of the control group was either readmitted to the hospital or admitted to an emergency room within 90 days. In the group that used the app, that number was just over 20 percent. In addition, the average weight for the app group was about 9 pounds (4.1 kg) lighter than the control group and the average blood pressure was about 8 mmHg lower. Widmer said there was also a correlation between how often patients used the app and how much they improved on most metrics.
"Patients who had a more frequent number of logins and the amount of time they logged in, as that increased, the patients' blood pressure dropped more precipitously," he said. "So there was a dose-response [relationship] between the use of the intervention and the secondary measures of cardiovascular disease we examined. ... Patients were less stressed as they used the application more and had a better diet and more physical activity as they used the application more."
This study was unrelated to last year's iPad study, also conducted at the Mayo Clinic, for patients recovering from heart surgery in the hospital. Widmer said this study will be followed up by a larger trial, but there's no reason public and private hospitals can't start incorporating apps into cardiac rehabilitation now. He said several groups, including the VA, have expressed interest.