Features of remote rehabilitation using the developed mobile app in patients after cardiac bypass surgery

Abstract

Aim of the study: The aim of the study is to evaluate the features and availability of the developed remote rehabilitation program with the use of a mobile application in patients who have undergone coronary artery bypass surgery (CABG) and surgical correction of valvular heart disease (VHD). Material and methods of research: In the current epidemiological situation, to increase the availability of cardiorehabilitation for patients after open heart surgery, a mobile application with the program "Remote rehabilitation of patients who have undergone heart surgery" was developed. The remote rehabilitation program included 46 patients (median age 60.0 [53.0; 64.0]) who underwent cardiac surgery. Of these, 22 patients after CABG (median age 61.0 [53.0; 63.5]) and 24 patients after surgical correction of VHD (median age 59.5 [54.0; 63.75]). On the 5th day after the surgery, the developed application for remote rehabilitation was installed on the smartphone. It consisted of 5 sections: Dosed Walking, Therapeutic gymnastics, Diet, Psychology and Chat. After application installing and until the moment of discharge from the hospital, 3 classes with a total duration of 6 academic hours were conducted with each patient. After being discharged from the hospital the patients were recommended to use the mobile app for rehabilitation at home for 4 months. 4 months after the surgery the app usage statistics were evaluated and a telephone survey of the reasons for non-complience was conducted. Result(s): A total of 34 (74%) patients used the mobile app for remote rehabilitation. Of these, 24 (52.0%) used the app section "Dosed Walking" and "Therapeutic Gymnastics" at least 5 times a week for 4 months, 10 (22%) used the app no more than 10 times during the entire follow-up period, and 12 (26%) did not engage in remote rehabilitation using the app. 22% of patients received consultations with a cardiologist via chat in mobile app. The telephone survey revealed the main reasons for the irregular participation of patients in the remote rehabilitation program using the mobile app: lack of interest/desire to engage in physical rehabilitation - 16 (35%), problems with the Internet - 6 (13%), lack of time - 4 (8.5%), incorrect function of the app - 4 (8.5%). Conclusion(s): Insufficient adherence of patients after cardiac surgery to a remote rehabilitation program using a mobile application, associated with a lack of motivation in patients, was demonstrated. This implies the importance of developing and implementing further measures to increase the motivation and adherence of patients to participate in long-term remote cardiac rehabilitation programs.