Openly accessible

Implementation of telerehabilitation interventions for the self-management of cardiovascular disease: systematic review

Subedi, Narayan, Rawstorn, Jonathan C, Gao, Lan, Koorts, Harriet and Maddison, Ralph 2020, Implementation of telerehabilitation interventions for the self-management of cardiovascular disease: systematic review, JMIR mHealth and uHealth, vol. 8, no. 11, pp. 1-17, doi: 10.2196/17957.

Attached Files
Name Description MIMEType Size Downloads

Title Implementation of telerehabilitation interventions for the self-management of cardiovascular disease: systematic review
Author(s) Subedi, Narayan
Rawstorn, Jonathan CORCID iD for Rawstorn, Jonathan C orcid.org/0000-0002-9755-7993
Gao, LanORCID iD for Gao, Lan orcid.org/0000-0001-9734-1140
Koorts, HarrietORCID iD for Koorts, Harriet orcid.org/0000-0003-1303-6064
Maddison, RalphORCID iD for Maddison, Ralph orcid.org/0000-0001-8564-5518
Journal name JMIR mHealth and uHealth
Volume number 8
Issue number 11
Article ID e17957
Start page 1
End page 17
Total pages 17
Publisher JMIR Publications Inc.
Place of publication Toronto, Ont.
Publication date 2020-11
ISSN 2291-5222
2291-5222
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
heart diseases
cardiac rehabilitation
telerehabilitation
implementation science
smartphone
systematic review
Summary Background Coronary heart disease (CHD) is a leading cause of disability and deaths worldwide. Secondary prevention, including cardiac rehabilitation (CR), is crucial to improve risk factors and to reduce disease burden and disability. Accessibility barriers contribute to underutilization of traditional center-based CR programs; therefore, alternative delivery models, including cardiac telerehabilitation (ie, delivery via mobile, smartphone, and/or web-based apps), have been tested. Experimental studies have shown cardiac telerehabilitation to be effective and cost-effective, but there is inadequate evidence about how to translate this research into routine clinical practice. Objective This systematic review aimed to synthesize research evaluating the effectiveness of implementing cardiac telerehabilitation interventions at scale in routine clinical practice, including factors underlying successful implementation processes, and experimental research evaluating implementation-related outcomes. Methods MEDLINE, Embase, PsycINFO, and Global Health databases were searched from 1990 through November 9, 2018, for studies evaluating the implementation of telerehabilitation for the self-management of CHD. Reference lists of included studies and relevant systematic reviews were hand searched to identify additional studies. Implementation outcomes of interest included acceptability, appropriateness, adoption, feasibility, fidelity, implementation cost, penetration, and sustainability. A narrative synthesis of results was carried out. Results No included studies evaluated the implementation of cardiac telerehabilitation in routine clinical practice. A total of 10 studies of 2250 participants evaluated implementation outcomes, including acceptability (8/10, 80%), appropriateness (9/10, 90%), adoption (6/10, 60%), feasibility (6/10, 60%), fidelity (7/10, 70%), and implementation cost (4/10, 40%), predominantly from the participant perspective. Cardiac telerehabilitation interventions had high acceptance among the majority of participants, but technical challenges such as reliable broadband internet connectivity can impact acceptability and feasibility. Many participants considered telerehabilitation to be an appropriate alternative CR delivery model, as it was convenient, flexible, and easy to access. Participants valued interactive intervention components, such as real-time exercise monitoring and feedback as well as individualized support. The penetration and sustainability of cardiac telerehabilitation, as well as the perspectives of CR practitioners and health care organizations, have received little attention in existing cardiac telerehabilitation research. Conclusions Experimental trials suggest that participants perceive cardiac telerehabilitation to be an acceptable and appropriate approach to improve the reach and utilization of CR, but pragmatic implementation studies are needed to understand how interventions can be sustainably translated from research into clinical practice. Addressing this gap could help realize the potential impact of telerehabilitation on CR accessibility and participation as well as person-centered, health, and economic outcomes. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42019124254; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=124254
Language eng
DOI 10.2196/17957
Indigenous content off
Field of Research 1117 Public Health and Health Services
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30140814

Connect to link resolver
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 2 times in TR Web of Science
Scopus Citation Count Cited 1 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 49 Abstract Views, 0 File Downloads  -  Detailed Statistics
Created: Thu, 13 Aug 2020, 15:08:55 EST

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.