Adherence to a Lifestyle Monitoring System in Patients with Heart Disease

In cardiac rehabilitation (CR), technological innovations can help to improve patient relevant outcomes and reduce health care costs.Lifestyle and psychological wellbeing are considered pivotal in this field as physical fitness, daily physical activity levels, dietaryhabits, mental stress, sleep quality and smoking habit, are strongly related to the occurrence, clinical course and overall treatmentoutcomes of common cardiovascular diseases (CVD’s) such as coronary artery disease (CAD) and atrial fibrillation (AF). In fact,quality of life is often not improved after major cardiac interventions and persistent unhealthy lifestyle factors have adverse effects onthe clinical course of patients with coronary artery disease and atrial fibrillation. However, despite their undisputed relevance, theselifestyle factors are currently not objectively and subjectively monitored and therefore not optimally used to the advantage of patientsin daily clinical practice. We postulate that more insight in the patients’ daily lifestyle behaviour provides crucial information that canbe used to improve patient selection for cardiac interventions. In addition, objective and subjective monitoring can be used topersonalize lifestyle interventions, leading to improvements of in-hospital and long-term outpatient clinical care, as well as better self-motivation, quality of life and health status.

Adherence to continuously providing self-tracking data via automatically monitoring technologies is key. Without data provided by thepatients, personalized and improved treatment decisions cannot be made. However, there is a gap in literature regarding theadherence to continuous lifestyle monitoring technologies for a longer period of time. Whereas previous research showed high levelsof adherence associated with monitoring technology, these studies focused on relatively short programs. Secondly, studies typicallyfocus on monitoring only one lifestyle domain rather than a combination. Yet, the use of monitoring technology to improve fitness andwellbeing is a clear trend and may potentially be particularly useful as assistive tool to stimulate healthy lifestyle in specialpopulation. Therefore, there is a clear need for further research in evaluation of the adherence and usability of this kind of digitalhealth technology in CVD care and management.

This project aims to develop and evaluate the adherence and usability of a system that integrates innovative methods for continuousunobtrusive and patient-friendly monitoring of lifestyle factors (i.e. daily physical activity levels, dietary habits, mental stress andsleep quality) in patients with coronary artery disease (i.e. patients selected for coronary artery bypass surgery (CABG), a cardiacelectrophysiology test (EFO) and/or catheterization, a transcathethr aortic valve implantation (TAVI), or valve surgery). These patientgroups are selected because the diseases are common, treatment decisions are often complex, and technically and medicallysuccessful treatments are often not accompanied by optimal changes in lifestyle factors. A system that aids patients in monitoringtheir lifestyle factors will enable better self-management and improve self-motivation, with subsequent positive effects on the lifestylefactors themselves. Therefore, this study will investigate adherence to self-monitoring lifestyle with a novel integrated lifestylemonitoring system.

A drop-out rate of 50% at 1 year follow up is anticipated.

Inclusion: (one week) before cardiac intervention in the hospital.
Start of monitoring year: from intervention in hospital onwards.