Improving Cardiac Rehabilitation outcomes through mobile case management (iCARE)

项目摘要/摘要 心血管疾病(CVD)是世界上主要的死亡原因。全面心脏康复 (CR)计划已多次被证明可降低发病率和死亡率，同时改善症状和 这种慢性病患者的生活质量。而患者转诊到CR计划的比率 在冠状动脉事件或手术后，近年来逐渐开始增加，患者参与 这些项目并没有。此外，参加的患者的CR计划的遵守和完成情况也 远远达不到目标。参与和完成《公约》有许多已知的障碍，其中 大大缩小了CR推荐、注册和完成CR之间的差距。 本提案的目标是确定移动医疗(MHealth)远程病例的有效性 用于提高CR依从性、改善CVD风险因素和改善患者的管理平台- 以结果为中心。这项使用mHealth远程病例的CR前瞻性随机对照试验 与传统的以中心为基础的CR相比，通过交互开发了管理平台 与许多关键利益相关者合作，包括患者、临床CR支持人员、科学家、医生和 医疗保健行业的领导者。所有经历过心肌梗死、急性冠脉病变的非手术患者 综合征，经皮冠状动脉介入治疗，有稳定型心绞痛，或有心力衰竭会自动 已提交给CR，并有资格参与此试验。 我们预计，使用mHealth远程病例管理平台的患者将有所改善 临床结果与传统的以中心为基础的CR相比，通过增加对CR的依从性而得到证明 规划，改善心血管疾病风险因素，并改善再住院/死亡率。

PROJECT SUMMARY/ABSTRACT Cardiovascular disease (CVD) is the leading cause of death in the world. Comprehensive cardiac rehabilitation (CR) programs have repeatedly been shown to reduce morbidity and mortality while improving symptoms and quality of life for patients living with this chronic disease. While referral rates to CR programs for patients following a coronary event or procedure have slowly begun to increase in recent years, patient participation in these programs has not. Further, adherence and completion of CR programs for those patients enrolled also falls well short of target. There are a number of known barriers to participation in and completion of CR, which contribute substantially the widening gap between CR referral, enrollment, and completion of CR. The objective of this proposal is to determine the effectiveness of a mobile health (mHealth) remote case management platform for increasing CR adherence, improving CVD risk factors, and improving patient- centered outcomes. This prospective, randomized controlled trial of CR using a mHealth remote case management platform compared to conventional center-based CR has been developed through interaction with a number of key stakeholders including patients, clinical CR support staff, scientists, physicians, and healthcare leaders. All non-surgical patients who have experienced a myocardial infarction, acute coronary syndrome, percutaneous coronary intervention, have stable angina, or have heart failure will automatically be referred to CR and be eligible to participate in this trial. We anticipate that patients who utilize the mHealth remote case management platform will have improved clinical outcomes compared to conventional center-based CR, as evidenced by increased adherence to CR programming, improved CVD risk factors, and improved rehospitalizations/mortality.