Comparison of patient characteristics and health outcomes between self-selected conventional and digitally enhanced cardiac rehabilitation - a prospective cohort study

Abstract Background Data on self-selected modes of delivery of cardiac rehabilitation (CR) are limited. This study compared conventional CR (conCR) with digitally enhanced CR (deCR) in terms of patient characteristics, change in physical and mental functioning, and achievement of guideline-directed treatment goals. Method From May 2022 to December 2023, consecutive patients with cardiovascular diseases were enrolled at a tertiary centre into a 3-month conCR or deCR programme based on shared decision-making. Changes in cardiorespiratory fitness, anxiety, depression, and health-related quality of life (hrQoL) from admission to the discharge assessment were compared between CR modalities. The achievement of two-step blood pressure and LDL-cholesterol (LDL-C) goals, as well as the HbA1c goal in patients with diabetes at the discharge assessment was compared between CR modalities. Results Out of 1292 patients screened, 406 were eligible and completed the study. Of those 72% chose conCR and 28% chose deCR (Figure 1). Patients in deCR were three years younger, exhibited higher baseline peak VO2 (91% vs. 80% of predicted), better hrQoL, and lower depression and anxiety scores. No significant differences were found in improvements in physical or mental functioning, or in meeting blood pressure and HbA1c targets between the two groups (Figure 1). A smaller proportion of deCR participants achieved the LDL-C step 2 target (30% vs. 41% in conCR). Conclusion Overall, deCR attracted slightly younger patients with better baseline health, but both modalities showed similar effects on most health outcomes. ConCR was associated with tighter lipid control, which could be related to more intense counselling or patient preference.Figure 1