Developing a Cardiac TeleRehabilitation model using co-production with patients, family members, and healthcare professionals

AIMS: To describe how telemedicine in cardiac rehabilitation can be optimized through the development of a co-produced, family-focused Cardiac TeleRehabilitation model. METHODS AND RESULTS: A co-production approach was used to collaboratively develop a cardiac telerehabilitation model with eight cardiac patients, three family members, and eight healthcare professionals through three workshops. Data were analysed iteratively after each workshop using an inductive, semantic-level approach inspired by Braun and Clarke's thematic analysis, identifying themes from explicit data content. We first identified the needs, barriers, and facilitators associated with video consultations and home monitoring in cardiac rehabilitation. We gained a deeper understanding of the participants' expectations, preferences, and challenges in adopting video consultations and home monitoring. Six themes emerged from the workshops: (i) Trust and relationship building initiated by the first in-person consultation; (ii) communication and presence in a digital setting; (iii) inclusion of family members; (iv) digital competencies and technical readiness; (v) informed decision-making and patient autonomy; and (vi) practicality, flexibility, and organizational readiness. These themes shaped a cardiac telerehabilitation model, comprising video consultations, home monitoring, manuals, a nurse support tool, and a patient decision tool. CONCLUSION: Through co-productive workshops with patients, family members, and healthcare professionals, a cardiac telerehabilitation model was developed to support the use of video consultations and home monitoring. The model is intended to support the delivery of flexible, accessible rehabilitation tailored to each patient's individual needs. The model requires further evaluation in more diverse settings before broader implementation. REGISTRATION: Part of ClinicalTrials.gov (NCT06320652).