Improving Cardiac Rehabilitation outcomes through mobile case management (iCARE)

项目概要/摘要 心血管疾病（CVD）是世界上主要的死亡原因。综合心脏康复 (CR) 计划已多次被证明可以降低发病率和死亡率，同时改善症状和 患有这种慢性病的患者的生活质量。虽然患者转诊至 CR 计划的比例 近年来，冠状动脉事件或手术后的患者参与度开始缓慢增加 这些程序还没有。此外，参加的患者还遵守并完成 CR 计划 远远低于目标。参与和完成 CR 存在许多已知的障碍，其中 大大缩小了 CR 转诊、注册和 CR 完成之间不断扩大的差距。 该提案的目的是确定移动医疗 (mHealth) 远程案例的有效性 管理平台，用于提高 CR 依从性、改善 CVD 危险因素并改善患者 以结果为中心。这项使用 mHealth 远程病例进行 CR 的前瞻性、随机对照试验 与传统的基于中心的CR相比，管理平台是通过交互开发的 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 医疗保健领导者。所有经历过心肌梗塞、急性冠状动脉疾病的非手术患者 综合征、经皮冠状动脉介入治疗、稳定型心绞痛或心力衰竭将自动被纳入 提交给 CR 并有资格参加本试验。 我们预计使用 mHealth 远程病例管理平台的患者将会得到改善 与传统中心 CR 相比的临床结果，CR 依从性增加就证明了这一点 规划、改善 CVD 风险因素并改善再住院率/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.