Feasibility and effectiveness of an integrative cardiac rehabilitation employing smartphone technology (I-CREST): a pilot randomized controlled trial.

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 with a centre-based cardiac rehabilitation (CBCR) programme.

METHODS AND

RESULTS

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. Out of 2825 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 with CBCR.

CONCLUSION

This pilot study demonstrated the feasibility of the I-CREST programme, 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.

REGISTRATION: ClinicalTrials.gov: NCT05270993.