Effects of an eHealth Cardiac Exercise Rehabilitation Platform for Patients After Percutaneous Coronary Intervention Based on the Persuasive Systems Design Model: Randomized Controlled Trial

BACKGROUND: Cardiac exercise rehabilitation is an important intervention for disease management of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Still, the participation and compliance with exercise rehabilitation remain suboptimal. Mobile health technology is a promising approach to promoting involvement in cardiac exercise rehabilitation. Remote rehabilitation can overcome the problems existing in traditional rehabilitation. OBJECTIVE: This study aimed to evaluate the effects of an eHealth cardiac rehabilitation (CR) platform based on the persuasive systems design model in addition to standard CR after PCI on physical activity (PA), exercise endurance, self-perceived fatigue, exercise self-efficacy (ESE), and quality of life for patients after PCI. METHODS: A single-blinded, parallel, randomized controlled trial design was used. The study was conducted in the Department of Cardiology of a tertiary hospital in Hangzhou, China. A total of 180 eligible patients with CHD were enrolled from June to December 2023. Participants were randomly assigned (1:1) to the intervention group or the control group, with 90 patients in each group. The study is a 24-week eHealth CR program. The primary outcome was PA level; the secondary outcomes included exercise endurance, self-perceived fatigue, ESE, and quality of life. Data on the primary and secondary outcome measures were collected at baseline (T0), at 12 weeks of intervention (T1), and at 4 (T2), 8 (T3), and 12 (T4) weeks of follow-up. The generalized estimating equation model was used to examine changes in the outcome variables between the 2 groups across the study end points. RESULTS: Generalized estimating equation analyses revealed significant group-by-time interactions for all outcome measures (all P