The SharedHeart Approach: Technology-Supported Shared Decision Making to Increase Physical Activity in Cardiac Patients

Abstract

After a cardiac event, patients typically enroll in a cardiac rehabilitation program in a rehabilitation center, where physiotherapists guide them in overcoming their fear to move and increasing physical activity. Effectively changing patients' health behaviour and bringing the newly formed habits to their home environment remains challenging. At home, patients experience difficulties interpreting exercise targets and monitoring physical activity. To bridge the gap between supervised rehab in the center and regular exercise in daily life, we propose a shared decision making (SDM) approach SharedHeart that supports patients in changing their health behaviour and transferring the knowledge and healthy habits to their homes. We developed 3 applications that support patients and physiotherapists in following a SDM approach: (1) a tablet app to record the patient's sports preferences, (2) a caregiver dashboard to create and follow up on a patient-tailored exercise plan during and in between SDM encounters, and (3) a mobile app to report and follow up on physical activity at home. In this paper, we present the results of our survey investigating physiotherapists' application of SDM in their current practice and perceived usefulness of SDM and supporting tools. Next, we discuss our proposed SDM approach on the conceptual level and the guideline-based design of the supporting IT applications. We conclude by highlighting how our approach and tools align with physiotherapists' needs.