{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:33:19Z","timestamp":1787495599981,"version":"build-2736575974"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"ICT Policy Support Programme","award":["325158"],"award-info":[{"award-number":["325158"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims\u2003<\/jats:title>\n                    <jats:p>Current cardiac telerehabilitation (CTR) interventions are insufficiently tailored to the preferences and competences of individual patients, which raises the question whether their implementation will increase overall participation and adherence to cardiac rehabilitation (CR). However, research on patient-specific factors that influence participation and adoption of CTR interventions is scarce. The aim of this study was to evaluate which patient-related characteristics influence participation in a novel CTR intervention in patients with coronary artery disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results\u2003<\/jats:title>\n                    <jats:p>This prospective observational substudy of the SmartCare-CAD randomized controlled trial evaluated patient characteristics of study participants as proxy for participation in a CTR intervention. We compared demographic, geographic, and health-related characteristics between trial participants and non-participants to determine which characteristics influenced trial participation. A total of 699 patients (300 participants and 399 non-participants; 84% male, mean age 64.3\u2009\u00b1\u200910.5\u2009years) were included. Most of the non-participants refused participation because of insufficient technical skills or lack of interest in digital health (26%), or preferred centre-based CR (21%). Variables independently associated with non-participation included: higher age, lower educational level, shorter travelling distance, smoking, positive family history for cardiovascular disease, having undergone coronary artery bypass grafting; and a higher blood pressure, worse exercise capacity, and higher risk of depression before the start of CR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Participation in CTR is strongly influenced by demographic and health-related factors such as age, educational level, smoking status, and both physical and mental functioning. Cardiac telerehabilitation interventions should therefore be redesigned with the involvement of these currently underrepresented patient subgroups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztab105","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T21:13:41Z","timestamp":1639170821000},"page":"81-89","source":"Crossref","is-referenced-by-count":33,"title":["Predictors of non-participation in a cardiac telerehabilitation programme: a prospective analysis"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8409-2357","authenticated-orcid":false,"given":"Rutger Willem Maurice","family":"Brouwers","sequence":"first","affiliation":[{"name":"Department of Cardiology, M\u00e1xima Medical Center , De Run 4600, Postbus 7777 , 5500 MB Veldhoven, The Netherlands"},{"name":"Vitality Center, M\u00e1xima Medical Center , Eindhoven\/Veldhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Brini","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Computer Science, Eindhoven University of Technology , Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin Wilhelmus Franciscus Henricus","family":"Kuijpers","sequence":"additional","affiliation":[{"name":"Department of Cardiology, M\u00e1xima Medical Center , De Run 4600, Postbus 7777 , 5500 MB Veldhoven, The Netherlands"},{"name":"Vitality Center, M\u00e1xima Medical Center , Eindhoven\/Veldhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozua Johannes","family":"Kraal","sequence":"additional","affiliation":[{"name":"Department of Human-Centered Design, Faculty of Industrial Design Engineering, Delft University of Technology , Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareld Marijn Clemens","family":"Kemps","sequence":"additional","affiliation":[{"name":"Department of Cardiology, M\u00e1xima Medical Center , De Run 4600, Postbus 7777 , 5500 MB Veldhoven, The Netherlands"},{"name":"Vitality Center, M\u00e1xima Medical Center , Eindhoven\/Veldhoven, The Netherlands"},{"name":"Department of Industrial Design, Eindhoven University of Technology , Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"2022111811284144000_ztab105-B1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","author":"Dibben","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"2022111811284144000_ztab105-B2","doi-asserted-by":"crossref","first-page":"e2011686","DOI":"10.1001\/jamanetworkopen.2020.11686","article-title":"Association of cardiac rehabilitation with all-cause mortality among patients with cardiovascular disease in the Netherlands","volume":"3","author":"Eijsvogels","year":"2020","journal-title":"JAMA Netw Open"},{"key":"2022111811284144000_ztab105-B3","doi-asserted-by":"crossref","first-page":"1756","DOI":"10.1177\/2047487320905719","article-title":"Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: update of the Cardiac Rehabilitation Outcome Study (CROS-II)","volume":"27","author":"Salzwedel","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B4","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1136\/heartjnl-2017-312809","article-title":"Cost-effectiveness of cardiac rehabilitation: a systematic review","volume":"104","author":"Shields","year":"2018","journal-title":"Heart"},{"key":"2022111811284144000_ztab105-B5","doi-asserted-by":"crossref","first-page":"3227","DOI":"10.1093\/eurheartj\/ehab484","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC)","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur Heart J"},{"key":"2022111811284144000_ztab105-B6","first-page":"1","article-title":"The role of cardiac rehabilitation in improving cardiovascular outcomes","author":"Taylor","year":"2021","journal-title":"Nat Rev Cardiol"},{"key":"2022111811284144000_ztab105-B7","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1007\/s12471-020-01492-0","article-title":"Predictors of cardiac rehabilitation referral, enrolment and completion after acute myocardial infarction: an exploratory study","volume":"29","author":"Brouwers","year":"2021","journal-title":"Neth Heart J"},{"key":"2022111811284144000_ztab105-B8","year":"2019"},{"key":"2022111811284144000_ztab105-B9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1161\/CIRCOUTCOMES.119.005902","article-title":"Tracking cardiac rehabilitation participation and completion among Medicare beneficiaries to inform the efforts of a national initiative","volume":"13","author":"Ritchey","year":"2020","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2022111811284144000_ztab105-B10","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1177\/2047487317724574","article-title":"The impact of drop-out in cardiac rehabilitation on outcome among coronary artery disease patients","volume":"24","author":"Pardaens","year":"2017","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B11","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1177\/2047487318781359","article-title":"Determinants of participation and risk factor control according to attendance in cardiac rehabilitation programmes in coronary patients in Europe: EUROASPIRE IV survey","volume":"25","author":"Kotseva","year":"2018","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B12","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1177\/2047487319832394","article-title":"e-Cardiology Working Group Position Paper: Overcoming challenges in digital health implementation in cardiovascular medicine","volume":"26","author":"Frederix","year":"2019","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B13","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.1177\/2047487320922926","article-title":"Future-proofing cardiac rehabilitation: Transitioning services to telehealth during COVID-19","volume":"28","author":"Thomas","year":"2021","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B14","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1093\/ehjdh\/ztaa005","article-title":"Cost-effectiveness of cardiac telerehabilitation in coronary artery disease and heart failure patients: systematic review of randomized controlled trials","volume":"1","author":"Scherrenberg","year":"2020","journal-title":"Eur Heart J - Digit Heal"},{"key":"2022111811284144000_ztab105-B15","doi-asserted-by":"crossref","first-page":"2754","DOI":"10.1016\/j.jacc.2021.03.328","article-title":"Effectiveness of cardiac telerehabilitation with relapse prevention: SmartCare-CAD randomized controlled trial","volume":"77","author":"Brouwers","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2022111811284144000_ztab105-B16","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s12471-020-01432-y","article-title":"Cardiac telerehabilitation as an alternative to centre-based cardiac rehabilitation","volume":"28","author":"Brouwers","year":"2020","journal-title":"Neth Heart J"},{"key":"2022111811284144000_ztab105-B17","article-title":"The future is now: a call for action for cardiac telerehabilitation in the COVID-19 pandemic from the secondary prevention and rehabilitation section of the European Association of Preventive Cardiology","author":"Scherrenberg","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B18","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.1177\/2047487317710803","article-title":"Clinical and cost-effectiveness of home-based cardiac rehabilitation compared to conventional, centre-based cardiac rehabilitation: results of the FIT@Home study","volume":"24","author":"Kraal","year":"2017","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B19","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1136\/heartjnl-2018-313189","article-title":"Effects and costs of real-time cardiac telerehabilitation: randomised controlled non-inferiority trial","volume":"105","author":"Maddison","year":"2019","journal-title":"Heart"},{"key":"2022111811284144000_ztab105-B20","doi-asserted-by":"crossref","first-page":"2373","DOI":"10.1016\/j.apmr.2018.06.027","article-title":"End users want alternative intervention delivery models: usability and acceptability of the REMOTE-CR exercise-based cardiac telerehabilitation program","volume":"99","author":"Rawstorn","year":"2018","journal-title":"Arch Phys Med Rehabil"},{"key":"2022111811284144000_ztab105-B21","doi-asserted-by":"crossref","first-page":"e111","DOI":"10.2196\/jmir.1672","article-title":"A holistic framework to improve the uptake and impact of ehealth technologies","volume":"13","author":"Van Gemert-Pijnen","year":"2011","journal-title":"J Med Internet Res"},{"key":"2022111811284144000_ztab105-B22","first-page":"326","article-title":"Attitudes towards acceptance of an innovative home-based and remote sensing rehabilitation protocol among cardiovascular patients in Shantou","volume":"13","author":"Fang","year":"2016","journal-title":"China. J Geriatr Cardiol"},{"key":"2022111811284144000_ztab105-B23","doi-asserted-by":"crossref","first-page":"e161","DOI":"10.2196\/mhealth.8352","article-title":"Mobile technology use across age groups in patients eligible for cardiac rehabilitation: Survey study","volume":"5","author":"Gallagher","year":"2017","journal-title":"JMIR mHealth uHealth"},{"key":"2022111811284144000_ztab105-B24","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1177\/1357633X16674087","article-title":"Evaluating barriers to adopting telemedicine worldwide: a systematic review","volume":"24","author":"Scott Kruse","year":"2018","journal-title":"J Telemed Telecare"},{"key":"2022111811284144000_ztab105-B25","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s12911-015-0157-3","article-title":"A cross-sectional study assessing determinants of the attitude to the introduction of eHealth services among patients suffering from chronic conditions eHealth\/telehealth\/mobile health systems","volume":"15","author":"Duplaga","year":"2015","journal-title":"BMC Med Inform Decis Mak"},{"key":"2022111811284144000_ztab105-B26","doi-asserted-by":"crossref","first-page":"e172","DOI":"10.2196\/jmir.3117","article-title":"Predictors of eHealth usage: insights on the digital divide from the Health Information National Trends Survey 2012","volume":"16","author":"Kontos","year":"2014","journal-title":"J Med Internet Res"},{"key":"2022111811284144000_ztab105-B27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12872-017-0477-6","article-title":"Effects of cardiac telerehabilitation in patients with coronary artery disease using a personalised patient-centred web application: protocol for the SmartCare-CAD randomised controlled trial","volume":"17","author":"Brouwers","year":"2017","journal-title":"BMC Cardiovasc Disord"},{"key":"2022111811284144000_ztab105-B28","volume-title":"Beslisboom Poliklinische Indicatiestelling Hartrevalidatie 2012","year":"2012"},{"key":"2022111811284144000_ztab105-B29","volume-title":"NVVC Practice Guidelines for Cardiac Rehabilitation","year":"2011"},{"key":"2022111811284144000_ztab105-B30","doi-asserted-by":"crossref","first-page":"1483","DOI":"10.1023\/B:QURE.0000040792.25240.38","article-title":"Quality of life after myocardial infarction: translation and validation of the MacNew Questionnaire for a Dutch population","volume":"13","author":"De Gucht","year":"2004","journal-title":"Qual Life Res"},{"key":"2022111811284144000_ztab105-B31","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch Intern Med"},{"key":"2022111811284144000_ztab105-B32","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J Gen Intern Med"},{"key":"2022111811284144000_ztab105-B33","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1080\/07350015.1988.10509663","article-title":"Missing-data adjustments in large surveys","volume":"6","author":"Little","year":"1988","journal-title":"J Bus Econ Stat"},{"key":"2022111811284144000_ztab105-B34","doi-asserted-by":"crossref","DOI":"10.1002\/9780470316696","volume-title":"Multiple Imputation for Nonresponse in Surveys","author":"Rubin","year":"1987"},{"key":"2022111811284144000_ztab105-B35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12911-016-0329-9","article-title":"Cardiac patients show high interest in technology enabled cardiovascular rehabilitation","volume":"16","author":"Buys","year":"2016","journal-title":"BMC Med Inform Decis Mak"},{"key":"2022111811284144000_ztab105-B36","doi-asserted-by":"crossref","first-page":"e172","DOI":"10.2196\/jmir.3117","article-title":"Predictors of ehealth usage: Insights on the digital divide from the health information national trends survey 2012","volume":"16","author":"Kontos","year":"2014","journal-title":"J Med Internet Res"},{"key":"2022111811284144000_ztab105-B37","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.2196\/jmir.5605","article-title":"Modelling and predicting eHealth usage in Europe: a multidimensional approach from an online survey of 13,000 European Union Internet Users","volume":"18","author":"Torrent-Sellens","year":"2016","journal-title":"J Med Internet Res"},{"key":"2022111811284144000_ztab105-B38","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.2196\/humanfactors.6217","article-title":"eHealth literacy: predictors in a population with moderate-to-high cardiovascular risk","volume":"4","author":"Richtering","year":"2017","journal-title":"JMIR Hum Factors"},{"key":"2022111811284144000_ztab105-B39","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1001\/jamacardio.2020.5218","article-title":"Effectiveness of home-based mobile guided cardiac rehabilitation as alternative strategy for nonparticipation in clinic-based cardiac rehabilitation among elderly patients in Europe: a randomized clinical trial","volume":"6","author":"Snoek","year":"2021","journal-title":"JAMA Cardiol"},{"key":"2022111811284144000_ztab105-B40","doi-asserted-by":"crossref","first-page":"2238","DOI":"10.1177\/2047487319882815","article-title":"Prognostic role of education levels after cardiac surgery and inhospital cardiac rehabilitation","volume":"27","author":"Lazzeroni","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2022111811284144000_ztab105-B41","doi-asserted-by":"crossref","first-page":"e046051","DOI":"10.1136\/bmjopen-2020-046051","article-title":"How has technology been used to deliver cardiac rehabilitation during the COVID-19 pandemic? An international cross-sectional survey of healthcare professionals conducted by the BACPR","volume":"11","author":"O'Doherty","year":"2021","journal-title":"BMJ Open"},{"key":"2022111811284144000_ztab105-B42","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1001\/jama.2021.18459","article-title":"Focusing on digital health equity","volume":"326","author":"Lyles","year":"2021","journal-title":"JAMA"},{"key":"2022111811284144000_ztab105-B43","first-page":"1","article-title":"Addressing equity in telemedicine for chronic disease management during the Covid-19 pandemic","author":"Nouri","year":"2020","journal-title":"NEJM Catal"},{"key":"2022111811284144000_ztab105-B44","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.conctc.2016.01.002","article-title":"Factors affecting patient participation in clinical trials in Ireland: a narrative review","volume":"3","author":"Walsh","year":"2016","journal-title":"Contemp Clin Trials Commun"},{"key":"2022111811284144000_ztab105-B45","doi-asserted-by":"crossref","first-page":"33","DOI":"10.21037\/mhealth.2019.08.06","article-title":"Listening to the patients: using participatory design in the development of a cardiac telerehabilitation web portal","volume":"5","author":"Joensson","year":"2019","journal-title":"mHealth"}],"container-title":["European Heart Journal - Digital Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjdh\/advance-article-pdf\/doi\/10.1093\/ehjdh\/ztab105\/41978244\/ztab105.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjdh\/article-pdf\/3\/1\/81\/47116263\/ztab105.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjdh\/article-pdf\/3\/1\/81\/47116263\/ztab105.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T03:05:32Z","timestamp":1726283132000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjdh\/article\/3\/1\/81\/6459171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,10]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12,10]]},"published-print":{"date-parts":[[2022,3,24]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjdh\/ztab105","relation":{},"ISSN":["2634-3916"],"issn-type":[{"value":"2634-3916","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,3,1]]},"published":{"date-parts":[[2021,12,10]]}}}