Digital cardiac rehabilitation – feasibility of the interdisciplinary, comprehensive 12-week eCardiacRehab programme
T M Norekval, T R Pettersen, I L Aksetoy, M Back, H Flagtvedt, R Gallagher, E Gerdts, M Hagen, A J Kjolseth, K N Naranjo, E R Pedersen, R J Ramstad, S Rotevatn, J D Schjott, H AlloreAbstract
Background
Digital cardiac rehabilitation (CR) has been suggested as an innovative approach to increase participation in CR. However, few programmes are comprehensive, assess physical/mental functioning and quality of life, and are not restricted by age and comorbidity burden.
Purpose
We tested application user-friendliness, recruitment, and attrition of the multicentre, comprehensive 12-week eCardiacRehab programme including physical tests and goal setting in an outpatient setting 2-4 weeks after percutaneous coronary intervention (PCI).
Methods
Patients were consecutively recruited following guideline-based inclusion criteria from January to October 2025 into three arms; i) eCardiacRehab allowing for tailored solutions according to patients’ functional abilities and needs, ii) Control group 1: usual care, iii) Control group 2: usual care and physical tests (e.g. cardiopulmonary exercise test, bioimpedance, and hand grip strength). All patients completed questionnaires, and all arms had pre-planned oversampling of women. Core components, health registrations, definition of personalised goals, and communication with the interdisciplinary CR team was key (Figure 1). User-friendliness was assessed with the Post-Study System Usability Questionnaire (PSSUQ). Programme metrics on engagement were established. Detailed flowcharts were developed for each arm.
Results
In total, 159 patients were included: 52 (38% women) in the intervention group, and 57 patients (44% women) in Control group 2. Median age was 66 (range 39-87) across the two groups, and the attrition rate was 25% at 12 weeks. Those lost to follow-up were older and living alone. Selected clinical variables are presented in Table 1. Pre-specified success criteria for inclusion (55%) and attrition rates (≤ 20%) were approached but not fully achieved. Success criteria were achieved on engagement with the programme and user-friendliness. Most modules were completed by 65-80% of patients, and reported as ‘Very useful’ or ‘Useful’. The overall PSSUQ score was 1.9, indicating high user satisfaction and excellent system usability. Notably, difficultly logging in was frequently reported. eCardiacRehab helped achieve goals on lifestyle changes (71%), and provided satisfactory support from clinicians (93%).
Conclusion
eCardiacRehab is both feasible and acceptable to patients after PCI, warranting further evaluation of clinical outcomes and cost-effectiveness in a larger efficacy trial. Refinements are required on recruitment strategies and technical barriers.Patient journey and contentTable 1Variables on completers/drop-out