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Smartphone-guided secondary prevention for patients with coronary artery disease

Felix Jansen's group shows how the collaboration between research institutions (Herzzentrum Bonn) and start-up companies (Vantis GmbH) can work to develop innovative treatment options for patients with coronary artery disease (CAD). They developed an app to integrate secondary prevention into the everyday life of patients with coronary artery diseases. The app provided a daily 15-minute program that included video-guided exercises, video sessions with background information about CAD, and a tool to record blood pressure and heart rate once a day. They could show that the regular use of the app appears to support lifestyle changes in patients with CAD.

app_pictureCoronary artery disease is the leading cause of death worldwide. In addition to the implantation of coronary stents and optimal medication, lifestyle adjustments are the basis for the prevention of cardiac events. Nevertheless, only about 30% of patients with coronary artery disease (CHD) manage to adapt their lifestyle after a heart attack and follow the recommendations of the professional associations in terms of exercise, diet and other behaviors. The remaining 70% of patients have an increased risk of recurring cardiac events despite optimal drug and interventional therapy. According to scientific studies, the following factors are largely responsible for the low rate of lifestyle adjustments in CHD patients: 1. the limited time the treating physicians have to give precise instructions for patients, 2. the difficulty of physical activity and a healthy diet in everyday life integrate, and 3. the sometimes long ways to rehabilitative measures such as coronary sports.

In order to overcome these hurdles, we have developed a smartphone app at the Heart Center Bonn in cooperation with a start-up company (Vantis GmbH). This app takes up the above-mentioned points and offered the patients video-guided exercise units, diet recommendations and knowledge videos with important information about CHD as well as the option of documenting blood pressure and pulse. In this way, the patients were able to regularly carry out scientifically established secondary prevention in their home environment and in their daily routine.
Our study with a total of 43 patients showed that 40% of the patients regularly used the app on at least 5 out of 7 days a week. Of these patients, 82% were more physically active than before using the app and 59% adjusted their eating habits. The use of the app was associated with an increase in knowledge about cardiovascular risk factors in 70% of the patients. The vast majority of patients (88%) reported an improved quality of life and a willingness to use the app for longer periods of more than 4 weeks (88%).

In summary, this pilot study shows that the use of a smartphone app represents a new innovative way of integrating secondary prevention into the everyday life of patients. Long-term use of a personalized app could lead to fewer cardiac events and fewer hospital stays for patients with CHD. To test this hypothesis, prospective randomized studies are necessary, which are currently being specifically planned at the Bonn Heart Center.
These first data also show the potential for cooperation between research institutions (University Hospital Bonn and Heart Center Bonn) and start-up companies (Vantis GmbH). The resulting synergy effects can create innovative products within a short period of time that have the potential to develop patient-centered solutions in order to be able to treat patients better.

Publication: Eckardt I, Buschhaus C, Nickenig G, Jansen F.; Smartphone-guided secondary prevention for patients with coronary artery disease; Journal of Rehabilitation and Assistive Technologies Engineering. 2021 Mar 16. doi:10.1177/2055668321996572



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