Improving Cardiac Rehabilitation outcomes through mobile case management (iCARE)

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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.