A digitally supported shared decision-making approach for patients during cardiac rehabilitation: a randomized controlled trial

Abstract

Aims The aim of the study is to evaluate the effectiveness of combining centre-based cardiac rehabilitation (CR) with shared decision-making (SDM) based telerehabilitation (TR) on patients' quality of life, cardiorespiratory fitness, and physical activity level. Methods and results A randomized controlled trial (NCT05026957) was conducted with 80 patients with heart disease recruited from Jessa Hospital, Hasselt. Patients were randomized to either a control group receiving standard CR or an intervention group receiving standard CR with additional SDM-based TR via the SharedHeart smartphone application. Primary outcome was quality of life (HeartQoL), while secondary outcomes included cardiorespiratory fitness (VO(2)peak) and physical activity levels. Data were analysed using a linear mixed model. The intervention group showed a greater improvement in quality of life [4.15 points, 95% confidence interval (CI): 0.7-7.6; P = 0.02], peak oxygen uptake (VO(2)peak) (1.1 mL/kg/min, 95% CI: 0.04-2.1; P = 0.04), and number of step count [14 788 more steps/7 days (95% CI: 4,2-25,3; P < 0.01)] over a 12-week intervention, compared with the control group. Conclusion This study demonstrated that the addition of SDM-based TR programme to centre-based CR significantly improved patients' quality of life, cardiorespiratory fitness, and physical activity levels compared with centre-based CR alone. The SharedHeart study stands out as one of the first to integrate a digitally supported SDM approach in CR, empowering patients to take an active role in their rehabilitation. Future research should focus on the long-term impact of digital interventions, particularly in reducing adverse cardiovascular events and enhancing patient self-management.