Web-based cardiac RE habilitatioN alternative for those declining or dropping out of conventional rehabilitation: Results of the WREN feasibility randomised controlled trial

Linzy Houchen-Wolloff; Nikki Gardiner; Reena Devi; Noelle Robertson; Kate Jolly; Tom Marshall; Gill Furze; Patrick Doherty; Ala Szczepura; John Powell; Sally Singh

doi:10.1136/openhrt-2018-000860

Web-based cardiac RE habilitatioN alternative for those declining or dropping out of conventional rehabilitation: Results of the WREN feasibility randomised controlled trial

Linzy Houchen-Wolloff, Nikki Gardiner, Reena Devi, Noelle Robertson, Kate Jolly, Tom Marshall, Gill Furze, Patrick Doherty, Ala Szczepura, John Powell, Sally Singh

School of Health and Care

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Abstract

Introduction Cardiac rehabilitation (CR) is typically delivered in hospital-based classes and is recommended to help people reduce their risk of further cardiac events. However, many eligible people are not completing the programme. This study aimed to assess the feasibility of delivering a web-based CR intervention for those who decline/drop out from usual CR. Intervention A web-based CR programme for 6 months, facilitated with remote support. Methods Two-centre, randomised controlled feasibility trial. Patients were randomly allocated to web-based CR/usual care for 6 months. Data were collected to inform the design of a larger study: recruitment rates, quality of life (MacNew), exercise capacity (incremental shuttle walk test) and mood (Hospital Anxiety and Depression Scale). Feasibility of health utility collection was also evaluated. Results 60 patients were randomised (90% male, mean age 62±9 years, 26% of those eligible). 82% completed all three assessment visits. 78% of the web group completed the programme. Quality of life improved in the web group by a clinically meaningful amount (0.5±1.1 units vs 0.2±0.7 units: control). Exercise capacity improved in both groups but mood did not change in either group. It was feasible to collect health utility data. Conclusions It was feasible to recruit and retention to the end of the study was good. The web group reported important improvements in quality of life. This intervention has the opportunity to increase access to CR for patients who would otherwise not attend. Promising outcomes and recruitment suggest feasibility for a full-scale trial. Trial registration number 10726798.

Original language	English
Article number	e000860
Journal	Open Heart
Volume	5
Issue number	2
DOIs	https://doi.org/10.1136/openhrt-2018-000860
Publication status	Published - 8 Oct 2018

Bibliographical note

Copyright information: © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY. Published by BMJ.
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by/4.0

Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

Funder

This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (grant reference number PB-PG-1013-32059). The work was also supported by the NIHR Leicester Biomedical Research Centre-Respiratory. LHW and SS are supported by NIHR CLAHRC East Midlands. KJ and TM are funded by the NIHR CLAHRC West Midlands. JP is supported by NIHR CLAHRC Oxford at Oxford Health NHS Foundation Trust.

Keywords

cardiac rehabilitation
delivery of care
education

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1136/openhrt-2018-000860Licence: CC BY

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Cite this

Houchen-Wolloff, L., Gardiner, N., Devi, R., Robertson, N., Jolly, K., Marshall, T., Furze, G., Doherty, P., Szczepura, A., Powell, J., & Singh, S. (2018). Web-based cardiac RE habilitatioN alternative for those declining or dropping out of conventional rehabilitation: Results of the WREN feasibility randomised controlled trial. Open Heart, 5(2), Article e000860. https://doi.org/10.1136/openhrt-2018-000860

Houchen-Wolloff, L, Gardiner, N, Devi, R, Robertson, N, Jolly, K, Marshall, T, Furze, G, Doherty, P, Szczepura, A, Powell, J & Singh, S 2018, 'Web-based cardiac RE habilitatioN alternative for those declining or dropping out of conventional rehabilitation: Results of the WREN feasibility randomised controlled trial', Open Heart, vol. 5, no. 2, e000860. https://doi.org/10.1136/openhrt-2018-000860

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title = "Web-based cardiac RE habilitatioN alternative for those declining or dropping out of conventional rehabilitation: Results of the WREN feasibility randomised controlled trial",

abstract = "Introduction Cardiac rehabilitation (CR) is typically delivered in hospital-based classes and is recommended to help people reduce their risk of further cardiac events. However, many eligible people are not completing the programme. This study aimed to assess the feasibility of delivering a web-based CR intervention for those who decline/drop out from usual CR. Intervention A web-based CR programme for 6 months, facilitated with remote support. Methods Two-centre, randomised controlled feasibility trial. Patients were randomly allocated to web-based CR/usual care for 6 months. Data were collected to inform the design of a larger study: recruitment rates, quality of life (MacNew), exercise capacity (incremental shuttle walk test) and mood (Hospital Anxiety and Depression Scale). Feasibility of health utility collection was also evaluated. Results 60 patients were randomised (90% male, mean age 62±9 years, 26% of those eligible). 82% completed all three assessment visits. 78% of the web group completed the programme. Quality of life improved in the web group by a clinically meaningful amount (0.5±1.1 units vs 0.2±0.7 units: control). Exercise capacity improved in both groups but mood did not change in either group. It was feasible to collect health utility data. Conclusions It was feasible to recruit and retention to the end of the study was good. The web group reported important improvements in quality of life. This intervention has the opportunity to increase access to CR for patients who would otherwise not attend. Promising outcomes and recruitment suggest feasibility for a full-scale trial. Trial registration number 10726798.",

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AU - Furze, Gill

AU - Doherty, Patrick

AU - Szczepura, Ala

AU - Powell, John

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N2 - Introduction Cardiac rehabilitation (CR) is typically delivered in hospital-based classes and is recommended to help people reduce their risk of further cardiac events. However, many eligible people are not completing the programme. This study aimed to assess the feasibility of delivering a web-based CR intervention for those who decline/drop out from usual CR. Intervention A web-based CR programme for 6 months, facilitated with remote support. Methods Two-centre, randomised controlled feasibility trial. Patients were randomly allocated to web-based CR/usual care for 6 months. Data were collected to inform the design of a larger study: recruitment rates, quality of life (MacNew), exercise capacity (incremental shuttle walk test) and mood (Hospital Anxiety and Depression Scale). Feasibility of health utility collection was also evaluated. Results 60 patients were randomised (90% male, mean age 62±9 years, 26% of those eligible). 82% completed all three assessment visits. 78% of the web group completed the programme. Quality of life improved in the web group by a clinically meaningful amount (0.5±1.1 units vs 0.2±0.7 units: control). Exercise capacity improved in both groups but mood did not change in either group. It was feasible to collect health utility data. Conclusions It was feasible to recruit and retention to the end of the study was good. The web group reported important improvements in quality of life. This intervention has the opportunity to increase access to CR for patients who would otherwise not attend. Promising outcomes and recruitment suggest feasibility for a full-scale trial. Trial registration number 10726798.

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Web-based cardiac RE habilitatioN alternative for those declining or dropping out of conventional rehabilitation: Results of the WREN feasibility randomised controlled trial

Abstract

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ASJC Scopus subject areas

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Ala Szczepura

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Web-based cardiac RE habilitatioN alternative for those declining or dropping out of conventional rehabilitation: Results of the WREN feasibility randomised controlled trial

Abstract

Bibliographical note

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Keywords

ASJC Scopus subject areas

Access to Document

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Fingerprint

Profiles

Ala Szczepura

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