User needs and preferences of athletes in cardiac(tele)rehabilitation: a qualitative study

Background Cardiac (tele)rehabilitation (CTR) is the core strategy in the secondary prevention of coronary artery disease (CAD). Research on patient-specific needs and preferences of athletes within cardiac rehabilitation (CR) is scarce. CTR is a promising approach for tailored rehabilitation in this specific population at risk for exercise-related events. Purpose To define the user needs and preferences of the athletic population in cardiac (tele)rehabilitation. Methods In this qualitative study we included fifteen athletes with established CAD who participated in a CR program, and twelve health care professionals. All athletes engaged in sports for at least four hours per week. This study consists of four phases: a stakeholder identification session, twenty-five semi-structured individual interviews, six card-sorting focus groups and a data analysis phase with thematic analysis. Results Fourteen male and one female athlete (mean age 63 ± 10.6 years) participated in cardiac rehabilitation after acute coronary syndrome, percutaneous coronary intervention and/or coronary bypass surgery. Healthcare professionals invited to participate included cardiac nurse practitioners, cardiologists, sports physicians, physiotherapists, and a clinical psychologist. User needs for athletes in CR encompass personalised exercise plans featuring clear and quantifiable exercise recommendations and limitations; Additionally, there is a need for monitoring health and exercise data, measuring progression and performance longitudinally, easy-to-use, and reliable healthcare information systems with accurate sensors and data; as well as clinical supervision and validation of information and data. Social support from both peers and family is also identified as a crucial need. The preferred technological features for a CTR system tailored for athletes include periodic digital consultations with clinicians, home-based training specific to one’s sport, utilization of technology to monitor workouts, data sharing and remote feedback, personalised exercise recommendations and online educational materials. Conclusion Enhancing CR for athletes’ necessities adopting a personalised and sport-specific methodology. The integration of various technological features within a CTR program can play a pivotal role in assisting athletes with CAD to regain their previous athletic performance levels and mitigate the risk of adverse cardiovascular events.