TY  - JOUR
AU  - Schmitz, Boris
AU  - Wirtz, Svenja
AU  - Sestayo-Fernández, Manuela
AU  - Schäfer, Hendrik
AU  - Douma, Emma R
AU  - Alonso Vazquez, Marta
AU  - González-Salvado, Violeta
AU  - Habibovic, Mirela
AU  - Gatsios, Dimitris
AU  - Kop, Willem Johan
AU  - Peña-Gil, Carlos
AU  - Mooren, Frank
PY  - 2024
DA  - 2024/2/22
TI  - Living Lab Data of Patient Needs and Expectations for eHealth-Based Cardiac Rehabilitation in Germany and Spain From the TIMELY Study: Cross-Sectional Analysis
JO  - J Med Internet Res
SP  - e53991
VL  - 26
KW  - eHealth
KW  - coronary artery disease
KW  - rehabilitation
KW  - mHealth
KW  - mobile health
KW  - mobile phone
KW  - app
KW  - apps
KW  - applications
KW  - personalized medicine
KW  - patient empowerment
KW  - living lab
KW  - coronary
KW  - cardiac
KW  - cardiology
KW  - heart
KW  - telehealth
KW  - telemedicine
KW  - monitoring
KW  - survey
KW  - surveys
KW  - experience
KW  - experiences
KW  - attitude
KW  - attitudes
KW  - opinion
KW  - perception
KW  - perceptions
KW  - perspective
KW  - perspectives
KW  - acceptance
KW  - technology use
KW  - usage
AB  - Background: The use of eHealth technology in cardiac rehabilitation (CR) is a promising approach to enhance patient outcomes since adherence to healthy lifestyles and risk factor management during phase III CR maintenance is often poorly supported. However, patients’ needs and expectations have not been extensively analyzed to inform the design of such eHealth solutions. Objective: The goal of this study was to provide a detailed patient perspective on the most important functionalities to include in an eHealth solution to assist them in phase III CR maintenance. Methods: A guided survey as part of a Living Lab approach was conducted in Germany (n=49) and Spain (n=30) involving women (16/79, 20%) and men (63/79, 80%) with coronary artery disease (mean age 57 years, SD 9 years) participating in a structured center-based CR program. The survey covered patients’ perceived importance of different CR components in general, current usage of technology/technical devices, and helpfulness of the potential features of eHealth in CR. Questionnaires were used to identify personality traits (psychological flexibility, optimism/pessimism, positive/negative affect), potentially predisposing patients to acceptance of an app/monitoring devices. Results: All the patients in this study owned a smartphone, while 30%-40% used smartwatches and fitness trackers. Patients expressed the need for an eHealth platform that is user-friendly, personalized, and easily accessible, and 71% (56/79) of the patients believed that technology could help them to maintain health goals after CR. Among the offered components, support for regular physical exercise, including updated schedules and progress documentation, was rated the highest. In addition, patients rated the availability of information on diagnosis, current medication, test results, and risk scores as (very) useful. Of note, for each item, except smoking cessation, 35%-50% of the patients indicated a high need for support to achieve their long-term health goals, suggesting the need for individualized care. No major differences were detected between Spanish and German patients (all P>.05) and only younger age (P=.03) but not sex, education level, or personality traits (all P>.05) were associated with the acceptance of eHealth components. Conclusions: The patient perspectives collected in this study indicate high acceptance of personalized user-friendly eHealth platforms with remote monitoring to improve adherence to healthy lifestyles among patients with coronary artery disease during phase III CR maintenance. The identified patient needs comprise support in physical exercise, including regular updates on personalized training recommendations. Availability of diagnoses, laboratory results, and medications, as part of a mobile electronic health record were also rated as very useful. Trial Registration: ClinicalTrials.gov NCT05461729; https://clinicaltrials.gov/study/NCT05461729 
SN  - 1438-8871
UR  - https://www.jmir.org/2024/1/e53991
UR  - https://doi.org/10.2196/53991
UR  - http://www.ncbi.nlm.nih.gov/pubmed/38386376
DO  - 10.2196/53991
ID  - info:doi/10.2196/53991
ER  -