Damery, Sarah, Jones, Janet, Harrison, Alexander orcid.org/0000-0002-2257-6508 et al. (2 more authors) (2025) Technology-enabled hybrid cardiac rehabilitation:Qualitative study of healthcare professional and patient perspectives at three cardiac rehabilitation centres in England. PLOS ONE. e0319619. ISSN 1932-6203
Abstract
Coronary heart disease (CHD) is a leading cause of death in the UK. Clinical guidelines recommend cardiac rehabilitation (CR), including health education, cardiovascular risk reduction advice, physical activity and stress management components. However, uptake of standard in-person, group-based CR is only around 50%. Hybrid cardiac rehabilitation (CR), combining in-person and remote service delivery, may improve CR uptake and reduce inequalities in service access. This study used focus groups and semi-structured interviews to explore staff and patient experiences of using the Active+me REMOTE hybrid CR app, a cloud-based platform providing access to education modules, behaviour change support, live exercise classes, physical activity and health monitoring across three sites in the East of England. Twelve staff and six patients participated. Topic guides explored participants' experiences of delivering or receiving hybrid CR, barriers and facilitators associated with the hybrid CR pathway, and implications for future implementation of Active+me REMOTE. Qualitative data were collected remotely, audio-recorded and independently transcribed. Staff data were analysed deductively, using the Consolidated Framework for Implementation Research (CFIR). Patient data were analysed inductively using thematic analysis. Despite some technical issues and governance delays, Active+me REMOTE was perceived as acceptable, convenient and allowed tailoring of support to meet patients' needs and circumstances. Data upload from wearable devices (blood pressure monitors) allowed staff to monitor patients' progress and empowered patients to direct their recovery. Staff initially felt they should screen patients to ensure that hybrid CR was offered to digitally literate, physically active individuals, although screening became less common as staff familiarity with the app increased. Findings suggest that effective implementation of hybrid CR requires system-level resource to facilitate governance approvals and embed hybrid CR delivery as standard care. Sufficient time must be allowed for staff training and to support patient enrolment to hybrid services. The study was registered on 3/7/2023 (ISRCTN320764).
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2025 Damery et al. |
Keywords: | Humans,Male,Female,Cardiac Rehabilitation/methods,England,Middle Aged,Qualitative Research,Health Personnel,Aged,Adult,Focus Groups,Coronary Disease/rehabilitation,Exercise |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Health Sciences (York) The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) |
Depositing User: | Pure (York) |
Date Deposited: | 14 Mar 2025 10:40 |
Last Modified: | 14 Mar 2025 10:40 |
Published Version: | https://doi.org/10.1371/journal.pone.0319619 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1371/journal.pone.0319619 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:224446 |
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Filename: journal.pone.0319619.pdf
Description: Technology-enabled hybrid cardiac rehabilitation: Qualitative study of healthcare professional and patient perspectives at three cardiac rehabilitation centres in England
Licence: CC-BY 2.5