Factors determining the readiness of a patient with coronary artery disease to use telemedicine technologies for rehabilitation: prospective cohort study

Abstract

BACKGROUND: Despite its relevance and established efficiency, the third stage of cardiac rehabilitation (CR) lacks a universal solution. The longest rehabilitation period requires many resources and effort on the part of the healthcare system. Digital technologies rapidly developing and being introduced into medicine can significantly assist in organizing the CR process. The healthcare system is already mastered and actively adopting telemedicine technologies into daily practice. OBJECTIVE: We aimed to determine the patients’ preparedness for the upcoming surgical treatment of the chronic types of coronary artery disease to engage in remote cardiac rehabilitation programs using telemedicine technologies. MATERIALS AND METHODS: A study of 213 patients treated for artery disease and preparing for planned coronary bypass surgery was conducted. Gender, age, socioeconomic factors, and digital literacy were analyzed. The patients were offered one of two options for completing the third stage of CR: a standard option in which CR is performed under the supervision of a medical worker in a medical organization at the place of residence according to the recommendations received upon hospital discharge or an alternative in which CR is performed at home using remote monitoring under the supervision of specialists from the CR laboratory of the Research Institute for Complex Issues of Cardiovascular Diseases. Patients were divided into two groups based on their choice: those who agreed to participate in the outpatient stage of CR using telemedicine technologies (loyal patients) and those who refused to use telemedicine technologies (nonloyal patients). The factors indicating more loyalty were identified using survey data and correlation analysis, and a portrait of a patient eager to use remote rehabilitation programs was formed. RESULTS: Social factors, such as living in big cities (p 0.001) and having a spouse (p=0,030), were associated with increased loyalty to participating in CR via telemedicine technologies. Male gender (p 0.001), obesity (p 0.001), and smoking (p 0.001) were associated with the reluctance to participate in the alternative CR program. The education level (p=0.060) did not show a significant impact on the loyalty to use telemedicine technologies. CONCLUSION: 46% of patients were interested in using remotely controlled CR programs. The social factors determine the loyalty to telemedicine technologies in patients.