End Users Want Alternative Intervention Delivery Models: Usability and Acceptability of the REMOTE-CR Exercise-Based Cardiac Telerehabilitation Program

OBJECTIVE: Evaluate user experiences of an exercise-based cardiac telerehabilitation intervention (REMOTE-CR) that provided near universal access to real-time remote coaching and behavioural support from exercise specialists. DESIGN: Secondary analysis (12 week follow-up) of a parallel group, single blind, randomised controlled non-inferiority trial (ACTRN12614000843651). SETTING: Community-based cardiac rehabilitation. PARTICIPANTS: Adults with coronary heart disease who were eligible for outpatient cardiac rehabilitation. 82/162 trial participants were randomised to receive REMOTE-CR; 67 completed usability and acceptability assessment at 12-week follow-up. INTERVENTION: REMOTE-CR comprised 12 weeks of individualised exercise prescription, real-time physiological monitoring, coaching, and behavioural support, delivered via a bespoke telerehabilitation platform. OUTCOMES: Ease of use, satisfaction with the technology platform and intervention content, and demand for real-world implementation as an alternative to traditional centre-based programmes were assessed at 12-week follow-up. RESULTS: Components of usability and acceptability were positively evaluated by most participants (44-66/67, 66-99%). 58/67 (87%) would choose REMOTE-CR if it was available as a usual care service, primarily because it provides convenient and flexible access to real-time individualised support from exercise specialists. Technology challenges were rare and had little impact on user experiences or demand for REMOTE-CR. CONCLUSIONS: REMOTE-CR can extend the reach and impact of existing cardiac rehabilitation services by overcoming traditional participation barriers while preserving expert oversight. Adoption of emerging technologies should be accelerated to support dynamic, engaging, individualised intervention delivery models, but optimising overall cardiac rehabilitation participation rates will require multiple delivery models that are tailored to satisfy diverse participant preferences.