Cost Effectiveness and Functional Outcomes of Smartphone Cardiac Rehabilitation Assisted Self Management SCRAM versus Centre Based Cardiac Rehabilitation among Patients with Coronary Heart Disease in Southern India A Multicentre Randomized Clinical Trial

Abstract

ABSTRACT newlineBackground: Coronary Heart Disease (CHD) is the major cause of increasing mortality newlineworldwide, as well as in India. CHD has been successfully managed by medical and cardiac newlinerevascularization surgeries for the long time. Cardiac Rehabilitation (CR) programs play a newlinevital role in secondary health care management for post CHD. Benefits from various CR newlineprograms like centre based CR, home based CR and through telerehabilitation has been newlineproven all over the world including developing countries like India. But adherence to CR newlineprograms and cost effectiveness related to that has been studied least in India. Aim of this newlinestudy: To identify, analyse and compare the cost effectiveness and functional outcomes of newlineSmartphone Cardiac Rehabilitation Assisted self Management (SCRAM) versus Centre Based newlineCardiac Rehabilitation (CBCR) among Coronary Heart Disease patients (CHD) in Southern newlineIndia. Methodology: A multicentre randomized clinical trial has been done through purposive newlinesampling with 78 participants who fulfilled the selection criteria, and they have been divided newlineinto 39 each of CBCR and SCRAM groups by block randomization. CBCR group received newlineexercise programs in hospital or rehabilitation setup, whereas SCRAM group received it newlinethrough whatsapp video call based telerehabilitation. Baseline, after 24 weeks of intervention, newline3 months, 6 months and 1 year post intervention follow up outcome measures of 6MWTD, newlineTalk Test scores in VAS, SF36, cost effectiveness, HDL and HbA1c - 3 months Average were newlinerecorded for data analysis. Results: There was statistically significant improvement in all newlineoutcome measures within group post intervention comparison with pand#8804;0.05, whereas between newlinegroups comparison was not showing significant results. But in follow ups, gained results newlineduring both interventions of CBCR or SCRAM were not statistically significant. Regarding newlinecost effectiveness, SCRAM group showed statistically significant reduction in cost without newlinecompromising functional outcomes and quality of life in CHD p