{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:35:47Z","timestamp":1784097347476,"version":"3.55.0"},"reference-count":35,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"unspecified","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Government of Ireland","award":["Sl\u00e1intecare Integration Fund 2019 (Agreement 121)"],"award-info":[{"award-number":["Sl\u00e1intecare Integration Fund 2019 (Agreement 121)"]}]},{"DOI":"10.13039\/501100001590","name":"Health Research Board","doi-asserted-by":"publisher","award":["Collaborative Doctoral Programme (CDA-2019-001)"],"award-info":[{"award-number":["Collaborative Doctoral Programme (CDA-2019-001)"]}],"id":[{"id":"10.13039\/501100001590","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,2,9]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The COVID-19 pandemic accelerated the uptake of digital health interventions for the delivery of cardiac rehabilitation (CR). However, there is a need to evaluate these interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We examined the impact of an evidence-based, digital CR programme on medical, lifestyle and psychosocial outcomes. Delivered by an interdisciplinary team of healthcare professionals, the core components of this 12-week programme included lifestyle modification, medical risk factor management, psychosocial and behavioural change support. To support self-management, patients were provided with a Fitbit, a home blood pressure (BP) monitor and an interactive workbook. Patients received access to a bespoke web-based platform and were invited to attend weekly, online group-based supervised exercise sessions and educational workshops. Outcomes were assessed at baseline, end of programme and at 6-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Over a 3-month period, 105 patients (88% with coronary heart disease) were referred with 74% (n=77) attending initial assessment. Of these, 97% (n=75) enrolled in the programme, with 85% (n=64) completing the programme, 86% (n=55) of completers attended 6-month follow-up. Comparing baseline to end of programme, we observed significant improvements in the proportion of patients meeting guideline-recommended targets for physical activity (+68%, p&lt;0.001), BP (+44%, p&lt;0.001) and low-density lipoprotein cholesterol (+27%, p&lt;0.001). There were significant reductions in mean weight (\u22122.6 kg, p&lt;0.001). Adherence to the Mediterranean diet score improved from 5.2 to 7.3 (p&lt;0.001). Anxiety and depression levels (Hospital Anxiety and Depression score) both reduced by more than 50% (p&lt;0.001). The majority of these improvements were sustained at 6-month follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Outcomes from this study suggest that interdisciplinary digital CR programmes can be successfully implemented and help patients achieve guideline recommended lifestyle, medical and therapeutic targets.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2022-002211","type":"journal-article","created":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T10:51:16Z","timestamp":1678963876000},"page":"e002211","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Harnessing digital health to optimise the delivery of guideline-based cardiac rehabilitation during COVID-19: an observational study"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5700-2280","authenticated-orcid":false,"given":"Irene","family":"Gibson","sequence":"first","affiliation":[{"name":"School of Medicine, University of Galway, Galway, Ireland"},{"name":"National Institute for Prevention and Cardiovascular Health, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"McCrudden","sequence":"additional","affiliation":[{"name":"Sligo University Hospital, Sligo, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Dunne","sequence":"additional","affiliation":[{"name":"Community Healthcare West, Health Service Executive West, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aisling","family":"Harris","sequence":"additional","affiliation":[{"name":"Cro\u00ed, West of Ireland Cardiac and Stroke Foundation, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Hynes","sequence":"additional","affiliation":[{"name":"Cro\u00ed, West of Ireland Cardiac and Stroke Foundation, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Murphy","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew William","family":"Murphy","sequence":"additional","affiliation":[{"name":"Discipline of General Practice, University of Galway, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Byrne","sequence":"additional","affiliation":[{"name":"Health Behaviour Change Research Group, University of Galway, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John William","family":"McEvoy","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Galway, Galway, Ireland"},{"name":"National Institute for Prevention and Cardiovascular Health, Galway, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"2025081710004576000_10.1.e002211.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"2025081710004576000_10.1.e002211.2","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1038\/s41569-021-00611-7","article-title":"The role of cardiac rehabilitation in improving cardiovascular outcomes","volume":"19","author":"Taylor","year":"2022","journal-title":"Nat Rev Cardiol"},{"key":"2025081710004576000_10.1.e002211.3","doi-asserted-by":"publisher","DOI":"10.1177\/2047487318825350"},{"key":"2025081710004576000_10.1.e002211.4","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2021-001659","article-title":"Interhospital and interindividual variability in secondary prevention: a comparison of outpatients with a history of chronic coronary syndrome versus outpatients with a history of acute coronary syndrome (the iaspire study)","volume":"8","author":"Curneen","year":"2021","journal-title":"Open Heart"},{"key":"2025081710004576000_10.1.e002211.5","doi-asserted-by":"crossref","DOI":"10.1007\/s11883-020-00889-x","article-title":"Digital health innovations to improve cardiovascular disease care","volume":"22","author":"Santo","year":"2020","journal-title":"Curr Atheroscler Rep"},{"key":"2025081710004576000_10.1.e002211.6","doi-asserted-by":"crossref","DOI":"10.5334\/gh.939","article-title":"Impacts of the COVID-19 pandemic on cardiac rehabilitation delivery around the world","volume":"16","author":"Ghisi","year":"2021","journal-title":"Glob Heart"},{"key":"2025081710004576000_10.1.e002211.7","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1161\/CIRCULATIONAHA.120.051769","article-title":"Pandemic intensifies push for home-based cardiac rehabilitation options","volume":"142","author":"Kuehn","year":"2020","journal-title":"Circulation"},{"key":"2025081710004576000_10.1.e002211.8","unstructured":"The British Heart Foundation. The national audit of cardiac rehabilitation quality and outcomes report 2021. 2021. Available: www.bhf.org.uk\/informationsupport\/publications\/statistics\/national-audit-of-cardiac-rehabilitation-quality-and-outcomes-report-2021 [Accessed 1 Nov 2022]."},{"key":"2025081710004576000_10.1.e002211.9","unstructured":"World Health Organization . WHO guideline: recommendations on digital interventions for health system strengthening: evidence and recommendations. Contract no.: WHO\/RHR\/19.10. Geneva: World Health Organization, 2019."},{"key":"2025081710004576000_10.1.e002211.10","doi-asserted-by":"crossref","DOI":"10.2196\/18773","article-title":"Digital health interventions for cardiac rehabilitation: systematic literature review","volume":"23","author":"Wongvibulsin","year":"2021","journal-title":"J Med Internet Res"},{"key":"2025081710004576000_10.1.e002211.11","article-title":"Home-Based versus centre-based cardiac rehabilitation","volume":"6","author":"Anderson","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2025081710004576000_10.1.e002211.12","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g1687","article-title":"Better reporting of interventions: template for intervention description and replication (tidier) checklist and guide","volume":"348","author":"Hoffmann","year":"2014","journal-title":"BMJ"},{"key":"2025081710004576000_10.1.e002211.13","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-147-8-200710160-00010"},{"key":"2025081710004576000_10.1.e002211.14","doi-asserted-by":"publisher","DOI":"10.1177\/1474515120924530"},{"key":"2025081710004576000_10.1.e002211.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2020.06.006"},{"key":"2025081710004576000_10.1.e002211.16","doi-asserted-by":"publisher","DOI":"10.1177\/2047487313498831"},{"key":"2025081710004576000_10.1.e002211.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60868-5"},{"key":"2025081710004576000_10.1.e002211.18","article-title":"Secondary prevention through comprehensive cardiovascular rehabilitation: from knowledge to implementation. 2020 update. A position paper from the secondary prevention and rehabilitation section of the European association of preventive cardiology","volume":"37","author":"Ambrosetti","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2025081710004576000_10.1.e002211.19","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2018-314206"},{"key":"2025081710004576000_10.1.e002211.20","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy339"},{"key":"2025081710004576000_10.1.e002211.21","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"2025081710004576000_10.1.e002211.22","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw106"},{"key":"2025081710004576000_10.1.e002211.23","doi-asserted-by":"publisher","DOI":"10.1016\/j.physio.2004.03.008"},{"key":"2025081710004576000_10.1.e002211.24","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2016-310477"},{"key":"2025081710004576000_10.1.e002211.25","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000000859"},{"key":"2025081710004576000_10.1.e002211.26","doi-asserted-by":"crossref","DOI":"10.2196\/17776","article-title":"The effectiveness of self-management of hypertension in adults using mobile health: systematic review and meta-analysis","volume":"8","author":"Li","year":"2020","journal-title":"JMIR Mhealth Uhealth"},{"key":"2025081710004576000_10.1.e002211.27","doi-asserted-by":"publisher","DOI":"10.1177\/0890117118816278"},{"key":"2025081710004576000_10.1.e002211.28","article-title":"Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care","volume":"11","author":"Weeks","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"2025081710004576000_10.1.e002211.29","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1093\/eurjcn\/zvac006","article-title":"Remote-delivered cardiac rehabilitation during COVID-19: a prospective cohort comparison of health-related quality of life outcomes and patient experiences","volume":"21","author":"Candelaria","year":"2022","journal-title":"Eur J Cardiovasc Nurs"},{"key":"2025081710004576000_10.1.e002211.30","doi-asserted-by":"publisher","DOI":"10.1177\/2047487314561168"},{"key":"2025081710004576000_10.1.e002211.31","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajpc.2020.100009","article-title":"Continuity of care and outpatient management for patients with and at high risk for cardiovascular disease during the COVID-19 pandemic: a scientific statement from the American society for preventive cardiology","volume":"1","author":"Khera","year":"2020","journal-title":"Am J Prev Cardiol"},{"key":"2025081710004576000_10.1.e002211.32","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","volume":"2020","author":"Scherrenberg","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2025081710004576000_10.1.e002211.33","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2015-000369","article-title":"Does the timing of cardiac rehabilitation impact fitness outcomes? an observational analysis","volume":"3","author":"Fell","year":"2016","journal-title":"Open Heart"},{"key":"2025081710004576000_10.1.e002211.34","unstructured":"Irish Heart Foundation and Irish Association for Cardiac Rehabilitation . Lifesaving cardiac rehabilitation service in crisis [press release]. 2021."},{"key":"2025081710004576000_10.1.e002211.35","doi-asserted-by":"crossref","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\u2019Doherty","year":"2021","journal-title":"BMJ Open"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2022-002211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:00:56Z","timestamp":1755450056000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2022-002211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,3,16]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/openhrt-2022-002211"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2022-002211","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}