i-CARE: A Smartphone-Based Intervention to Enhance Cardiac Rehabilitation in Coronary Artery Disease - A randomized controlled trial
Abstract
AIM
The global shortage of healthcare professionals creates challenges in managing chronic diseases. This study evaluated a remotely delivered, theory-based self-care support intervention, "Internet-based CArdiac Rehabilitation Enhancement (i-CARE)", delivered through a smartphone application to enhance self-management in patients with coronary artery disease (CAD).
METHODS
In this assessor-blinded, two-arm randomized controlled trial conducted at two regional hospitals in Hong Kong, community-dwelling adults with angiographically confirmed CAD were randomly assigned (1:1) to standard care or the i-CARE intervention. i-CARE included personalized risk assessment, skill-building, and app-based support to improve self-care behaviors. The primary outcome was change in CAD self-care behaviors, secondary outcomes were self-reported health status, health-related quality of life (HRQoL), physiological and biomarkers.
RESULTS
Of 294 participants randomized (n=147 per group), the i-CARE group showed significant greater improvements in self-care maintenance (ꞵ=4.055, 95%CI 1.420-6.691, p=0.003) and self-care confidence (ꞵ=5.609, 95%CI 1.089-10.129, p=0.015) at 3 months, sustained at 6 months. For secondary outcomes, the intervention also resulted in significant reductions in systolic (ꞵ=-3.725, 95%CI -7.322- -0.128, p=0.042) and diastolic (ꞵ= -2.153, 95%CI -4.228--0.079, p=0.042) blood pressure and improvements in HRQoL at 3 months (ꞵ=0.208, 95%CI 0.073-0.343, p=0.003), with persistent…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 294 participants or records.
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