Sian Claire Owen, medical journalist for Cardio Debate, UK

Heart failure has notoriously high re-hospitalisation rates, with nearly a quarter of all patients being readmitted within 30 days of an event. Exercise has been shown to reduce these rates of re-admission, however patient adherence remains problematic. [1] Furthermore, research into improving patient adherence have focused on the physiological impact of exercise, rather than patient adherence itself.

Therefore MOVE-HF (the Move on Virtual Engagement) pilot study utilised the Internet– including online video group discussions and activity monitors such as the Fitbit chargers – for providing feedback to patients and improving adherence to exercise. [1]

This 8-week, randomised controlled trial involved 30 patients with heart failure (NYHA class I-III HF with no change in clinical history over the previous 30 days), who were recruited from two cardiology practices. Patients were required to participate in a community walking programme of moderate intensity. The experimental group (n=15) were asked to keep weekly exercise diaries, kept a Fitbit charger HR, were provided with education on heart failure self care and – crucially – participated in weekly internet-based group meetings. The comparison group kept weekly exercise diaries, used Fitbit chargers and were provided with education on heart failure self care. [1]

The adherence to the weekly internet-based peer-group meetings was 68%, with 73.3% attending at least five of the eight sessions. However, there was little difference in terms of exercise adherence between the experimental and comparison groups (58.8% vs 57.3%, respectively). However it was noted that the size of the group meant that no significant impact on exercise adherence was observed.

Participants did report that they found the feedback from the Fitbit charger HR ‘helpful and motivational’. It is worth noting that some of the participants lived in rural areas, therefore the Internet-based peer discussion groups were particularly useful, and as the study authors state: ‘challenges faced with the use of technology can be overcome with adequate training.’

Therefore, the study authors conclude that the long-term impact of Internet-based peer group discussions and education sessions on adherence should be investigated.

References

  1. Deka P, Pozehl B, Williams MA, et al., MOVE-HF: An internet-based pilot study to improve adherence to exercise in patients with heart failure. Eur J Cardiovasc Nurs. 2018 Aug 21:1474515118796613.