Key result
A 12-week physical activity counseling and remote monitoring intervention significantly improved cardiorespiratory fitness (469 vs 494 m, P=0.0034) and self-reported physical activity (P=0.005).
Why the study?
Regular physical activity reduces CVD risk, but only about half of US adults achieve recommendations, leading to this evaluation of a clinical decision support tool for physical activity counseling.
Does an EHR-embedded physical activity counseling and Fitbit monitoring intervention improve physical activity and cardiovascular risk factors in preventive cardiology patients?
Does an EHR-embedded physical activity counseling and Fitbit monitoring intervention improve physical activity and cardiovascular risk factors in preventive cardiology patients?
Absolute Event Rate: 494% vs 469%
p-value: p=0.0034
An EHR-based physical activity counseling and remote monitoring intervention improved self-reported physical activity and cardiorespiratory fitness over 12 weeks in preventive cardiology patients.
May support EHR-based PA counseling in preventive clinics; leaves open effects on objective activity, adherence, or clinical outcomes.
BACKGROUND: Regular physical activity (PA) is a component of cardiovascular health and is associated with a lower risk of cardiovascular disease (CVD). However, only about half of US adults achieved the current PA recommendations. OBJECTIVE: The study purpose was to implement PA counseling using a clinical decision support tool in a preventive cardiology clinic and to assess changes in CVD risk factors in a sample of patients enrolled over 12 weeks of PA monitoring. METHODS: This intervention, piloted for 1 year, had 3 components embedded in the electronic health record: assessment of patients' PA, an electronic prompt for providers to counsel patients reporting low PA, and patient monitoring using a Fitbit. Cardiovascular disease risk factors included PA (self-report and Fitbit), body mass index, blood pressure, lipids, and cardiorespiratory fitness assessed with the 6-minute walk test. Depression and quality of life were also assessed. Paired t tests assessed changes in CVD risk. RESULTS: The sample who enrolled in the remote patient monitoring (n = 59) were primarily female (51%), White adults (76%) with a mean age of 61.13 ± 11.6 years. Self-reported PA significantly improved over 12 weeks ( P = .005), but not Fitbit steps ( P = .07). There was a significant improvement in cardiorespiratory fitness (469 ± 108 vs 494 ± 132 m, P = .0034), and 23 participants (42%) improved at least 25 m, signifying a clinically meaningful improvement. Only 4 participants were lost to follow-up over 12 weeks of monitoring. CONCLUSIONS: Patients may need more frequent reminders to be active after an initial counseling session, perhaps getting automated messages based on their step counts syncing to their electronic health record.
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McCarthy et al. (2023) studied Low physical activity and cardiovascular disease risk (n=59). Physical activity counseling and remote monitoring using a Fitbit vs. Baseline (pre-intervention) was evaluated on Cardiorespiratory fitness assessed with the 6-minute walk test (meters) (p=0.0034). A 12-week physical activity counseling and remote monitoring intervention significantly improved cardiorespiratory fitness (469 vs 494 m, P=0.0034) and self-reported physical activity (P=0.005).
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