Wearable Technology for Personalised Physical Activity Feedback in Cardiac Patients: A Feasibility Study

Cardiac rehabilitation (CR) is a comprehensive, long-term secondary care programme offered to individuals after a heart attack to aid recovery and prevent further illness. If properly implemented, CR is highly effective at reducing cardiac mortality, re-event, and re-admissions. Despite the well-established benefits, less than 50% of eligible UK patients enrol on a CR program. Among those who do begin CR in the UK, drop-out rates of 12-55% have been reported. If the take up of CR were increased to 65% it would reduce readmissions by a third and save approximately £100 million per year.Physical activity (PA) is the cornerstone of CR. With recent advances in wearable activity monitors, accurate and objective assessment of free-living PA is now possible. It is increasingly apparent that the health benefits of PA can be achieved in many ways, and multiple dimensions (or aspects) of PA are independently important. The most sophisticated wearable devices can be used to capture these different dimensions and provide a more comprehensive evaluation of free-living PA - enabling patients to understand their individual PA in the context of guidelines - and offering more behavioural options and personalised advice.In prior work, the investigators have developed a digital system for patients to self-manage their PA. This system comprises a wearable wrist-mounted accelerometer, bespoke digital platform, plus remote virtual support. The digital system has been customised for CR based on qualitative research in cardiac patients and practitioners - who found PA feedback to be understandable and motivating - and a route to address barrier to taking part in CR. This study aims to examine the feasibility of delivering a 6-week trial of a remote, technology-enabled physical activity intervention to patients who were unable to take up or dropped out of CR in the last 12 months.

Inclusion Criteria: Patients will be recruited in line with British Association for Cardiovascular Prevention and Rehabilitation (BACPR) guidelines, which states that the following priority patient groups shall be offered CR irrespective of age, sex, ethnic group, and clinical condition:Acute coronary syndromeCoronary revascularisationHeart failureOther patient groups known to benefit:Stable anginaPeripheral arterial diseasePost-cerebrovascular eventPost-implantation of cardiac defibrillators and resynchronisation devicesPost-heart valve repair/replacementPost-heart transplantation and ventricular assist devicesAdult congenital heart diseaseParticipants must also:Have access to a smart phone or tablet and the internetHave declined or dropped out of CR in the last 12 monthsExclusion Criteria: Patients who were not referred/deemed eligible for CR (assessed by clinical care team)No access to the internet and/or a smart phoneIndividuals who have completed CR in the last 12 monthsUnable to read EnglishUnable to understand written or verbal information