Long-term Effects of 3-Month Home-Based Cardiac Rehabilitation Using Information and Communication Technology for Heart Failure with Physical Frailty.

BACKGROUND

Information and communication technology (ICT)-supported home-based cardiac rehabilitation (HBCR) has gained prominence because of its potential advantages, including improved patient engagement. However, the long-term effects on patients with heart failure (HF) and physical frailty are unclear. The aim of this study was to determine the effects of HBCR on patients with HF and physical frailty 12 months after the HBCR intervention.

METHODS

This single-centre, single-arm intervention trial included 30 outpatients with chronic HF and physical frailty or pre-frailty. Participants received a comprehensive ICT-based HBCR intervention, including disease management, exercise, and nutritional guidance for 3 months, followed by a 12-month period of ICT-supported self-management without professional guidance. The primary outcome was the change in 6-minute walking distance (6MWD).

RESULTS

The 6MWD of the patients significantly improved at 3 months, compared with baseline (395.8 ± 16.2 metres [95% confidence interval (CI): 363.0-428.6] vs 445.1 ± 16.3 metres [95% CI, 412.0-478.2]; P < 0.01), but it decreased at 15 months, compared with 3 months (417.7 ± 16.3 metres [95% CI: 384.6-450.8]; P = 0.04). The frailty score also decreased at the 3-month vs the 15-month timepoint. Patients who continued to exercise at 15 months showed sustained improvement in 6MWD.

CONCLUSIONS

At 12 months after the intervention, the initial improvements in exercise tolerance and frailty were not maintained in the overall cohort. The ICT-supported self-management approach used in this study was insufficient to promote sustained behavioural change over the long term.