"The human side of care really matters" educational consultations in a digital home-based cardiac rehabilitation programme

Abstract Background Cardiac rehabilitation (CR) is recommended for patients following percutaneous coronary intervention (PCI), yet worldwide participation and completion remain critically low. Evidence suggests that individualised follow-up and support increase adherence and completion within standard CR settings. Academic detailing (AD) is an established intervention to promote behaviour change among health professionals, grounded in principles such as adult learning, motivational interview and social cognitive theory. However, the application of AD to patient education is sparse. Thus, we developed patient detailing (PD) to support evidence-based modules and patient needs in a digital home-based CR programme (eCardiacRehab) targeting post-PCI patients. Purpose To assess the feasibility and acceptability of PD in post-PCI patients within the eCardiacRehab programme. Methods PD consultations were provided one-to-one through video or telephone and included key techniques from AD, such as motivational interviewing. The approach was informed by teach-back principles and supplemented by patients` self-registrations in eCardiacRehab to guide the PD consultations. A PowerPoint presentation, with illustrations aligned with eCardiacRehab educational modules (e.g. medications, physical activity, nutrition, nicotine cessation, cholesterol and hypertension, women and cardiac disease, psychosocial health and sexuality, diabetes), served as a framework for discussions around four central themes: experience, motivation, mastering, and follow-up (Figure 1). PD consultation frequency and modules discussed were tailored according to the patient`s preference, although three consultations within the 12-week eCardiacRehab programme duration were set as standard. To mitigate avoidance of challenging and time-consuming issues, consultations explicitly addressed participation-related challenges and barriers identified at eCardiacRehab initiation. Results A total of 40 patients received 110 PD consultations, comprising 51 consultations by video and 59 by telephone. The median (range) duration of the consultations were 20 (7-60) minutes. The target of three consultations was achieved for most patients, with the number of consultations ranging from one to four. The most frequently discussed module was physical activity, followed by nutrition. Implementation of PD in eCardiacRehab was feasible, and participants expressed satisfaction with the personalised follow-up provided through PD. Conclusion Individualised educational consultations (PD) in a digital home-based CR programme is feasible and acceptable for patients following PCI. These results support the integration of PD into eCardiacRehab and further evaluation of its effectiveness in improving adherence and secondary preventive behaviours.Figure 1Central illustration