Behavioural and psychological telehealth support for people with cardiac conditions: Randomised trial of the ‘Back on Track’ self-management program

Abstract Aims Behaviour modification and mood management are essential to recovery after a cardiac event. Recent times have seen a major shift to remote delivery of cardiac services. This study assessed behavioral and psychological outcomes of the Back on Track online self-management program, comparing the program undertaken alone (self-directed) versus with telephone support (supported). Relevance for people with depression was also assessed. Methods and Results Participants with cardiac conditions (N = 122) were randomly assigned to self-directed or supported groups and given access to the online program for 2 months. The program addressed depression, anxiety, physical activity, and healthy eating. Supported group participants also received two telephone sessions facilitated by a trained counsellor to further enhance their self-management skills and engagement with the online modules. The Patient Health Questionnaire-9, Generalised Anxiety Disorder-7, Active Australia Survey and Diet Quality Tool were administered at baseline, 2 and 6 months. Chi-square tests were used to compare self-directed and supported groups. Cochrane’s Q tests assessed changes over time in depression, anxiety, and physical activity (PA) and healthy diet guideline achievement. Participants in both groups showed reduced depression rates (self-directed, p < .05) and increased PA after program completion (both groups, p < .05). Amongst those classified as depressed at baseline, significantly fewer were classified as depressed over time (p < .001) and significantly more were achieving the PA guidelines (p < .01) compared to those who were not depressed at baseline. Conclusions The Back on Track telehealth program was effective in assisting with behavioural and emotional recovery after a cardiac event. The program may be particularly beneficial for those who are depressed early in their recovery period. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620000102976; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378920&isReview=true