Technology-enabled Cardiac Rehabilitation Through PATHway. Feasibility, Clinical Effectiveness and Cost-effectiveness

Study Overview
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Brief Summary
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The PATHway system is designed to help patients remain physically active and maintain a good cardiovascular health. It proposes a novel approach that aims to empower patients to self-manage their CVD, set within a collaborative care context with health professionals. This will be achieved via a patient-centric holistic approach that specifically addresses the above barriers. It involves an internet-enabled and sensor-based home exercise platform. It is represented by several modules with an exercise module as the core component which will provide individualized rehabilitation programs that use regular, socially inclusive exercise sessions as the basis upon which to provide a personalized, comprehensive lifestyle intervention program (managing exercise, smoking, diet, stress, alcohol use etc.) to enable patients to both better understand and deal with their own condition and to lead a healthier lifestyle in general. The goal of this trial is to assess the acceptability, short-term effectiveness on lifestyle and health related physical fitness and cost-effectiveness of the PATHway intervention in patients with CVD in a single blind multicentre pilot randomised controlled trial (RCT).

Official Title
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Technology-enabled Cardiac Rehabilitation Through PATHway. Feasibility, Clinical Effectiveness and Cost-effectiveness

Conditions
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Cardiovascular Disease

Intervention / Treatment
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* Behavioral: PATHway


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men and women with documented CVD age 40-80 yrs patients are on optimal medical treatment and stable with regard to symptoms and pharmacotherapy for at least 4 weeks patients must have completed the ambulatory CR program and received clinical approval from their treating physician to continue exercising outside the hospital program internet access at home Exclusion Criteria: significant illness during the last 6 weeks known severe ventricular arrhythmia with functional or prognostic significance significant myocardial ischemia, hemodynamic deterioration or exercise-induced arrhythmia at baseline testing cardiac disease that limits exercise tolerance (valve disease with significant hemodynamic consequences, hypertrophic cardiomyopathy etc.) co-morbidity that may significantly influence one-year prognosis functional or mental disability that may limit exercise acute or chronic inflammatory diseases or malignancy, the use of anti-inflammatory drugs or immune suppression GFR <25ml/min/1.73m2 hemoglobin < 10g/dl severe chronic obstructive pulmonary disease (FEV1 < 50%) NYHA class 4 participation in another clinical trial

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PATHway<br>Patients allocated to the PATHway intervention will be given a 4 week run-in period as an outpatient to get acquainted with the system. During this run-in period, the PATHway system will also be installed in each participant's home. They will be provided with a training manual and a quick set up guide for getting started with PATHway in the home. After this 4 week run-in period, the PATHway system will be set up for each individual patient including a patient specific exercise prescription. The patient will then exercise with the PATHway platform for 6 months. | Behavioral: PATHway<br>* Patients will use the PATHway platform for 6 months<br>|
| No Intervention: Usual care<br>Patients randomized to the control group will receive usual care. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in total volume of weekly active energy expenditure |  | 3 and 6 months |