Coronary heart disease (CHD) Circulatory System Chronic ischaemic heart disease, unspecified
Conditions
Interventions
Intervention group: web-based cardiac rehabilitation using the 'Activate your Heart' online programme.
Control group: usual care.
Sponsors
University Hospitals of Leicester NHS Trust
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Confirmed primary diagnosis of coronary heart disease (CHD) 2. Eligible for conventional CR (eligibility as described in NICE CR commissioning guidelines 2013, section 3) 3. Access to internet. Questions will be asked to establish familiarity with the internet, e.g. use of either online shopping/online banking 4. People who have recently (<12 months) declined an invitation to rehabilitation. These people are defined as those at stage 2 (patient assessment) or stage 3 (when the patient care plan is developed) expressing an unwillingness to attend any further stages of the programme (stages defined in NICE commissioning guidelines 2013, section 1). People who prospectively decline at these stages will also be included 5. People who have recently (<12 months) ‘dropped-out’ of rehabilitation. These people are defined as those not attending 2 consecutive sessions of stage 4 comprehensive rehabilitation sessions (stages defined in NICE commissioning guidelines 2013, section 1)
Exclusion criteria
Exclusion criteria: 1. No access to the internet (it would be unrealistic to recruit people without access to the internet; it is beyond the scope of the project to provide the hardware to participants) 2. Individuals who have completed rehabilitation for a previous admission in the last 12 months 3. Those demonstrating high levels of depression (defined by baseline HADS score >11 [moderate depression]) and poor exercise capacity (defined by poor performance on the Incremental Shuttle Walking Test, level achieved <3 – equivalent to walking 120 metres). These patients will require a more supervised approach 4. Unable to read English. The website is currently only available in English
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome measured in this study is the feasibility of recruiting/retaining people who meet our inclusion and exclusion criteria; those who have declined/dropped out of traditional cardiac rehabilitation. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcome measures as of 20/12/2016: 1. Feasibility of our randomisation process and willingness to be randomised 2. Retention rate of participants to the study at 8 weeks, and 6 months follow-up 3. Feasibility of conducting outcome measures which are proposed for the final trial: 3.1. Health-related quality-of-life; 'MacNew Heart Disease Questionnaire', measuring physical, emotional, and social aspects of quality-of-life 3.2. Exercise Capacity; measured using the ‘Incremental Shuttle Walking Test (ISWT)’, which is a test used to assess cardio-respiratory fitness 3.3. Anxiety and Depression; measured using the ‘Hospital Anxiety and Depression Scale (HADS)' 3.4. Self-efficacy; measured using ‘The General Self-Efficacy Scale' 3.5. Health utility; measured using the 'EQ-5D' questionnaire. 3.6. 'Seattle Angina Questionnaire' (SAQ) 3.7. Angina Symptoms; Symptoms and medication use diary kept by the patient for 2 week, recording the frequency of episodes of angina and the number of glyceryl trinitrate (GTN) pills or ‘puffs’ of sub-lingual spray taken each day 3.8. Resource use: Including: use of hospital and community services; social care; and personal costs 3.9. Web usage: weekly and total web usage statistics for patients assigned to the web-based programme will be monitored as will any technical problems participants encounter 3.10. Intervention completion rates amongst intervention group participants Outcomes will be assessed at baseline, 8 weeks and 6 months in both groups. Original secondary outcome measures: 1. Feasibility of our randomisation process and willingness to be randomised 2. Retention rate of participants to the study at 8 weeks, and 6 months follow-up 3. Fea | — |
Countries
United Kingdom
Outcome results
None listed