Adherence to remote rehabilitation program after on-pump cardiac surgey in pandemic period

Objective. To assess the adherence to distant rehabilitation using a mobile application and secondary prevention guidelines after on-pump coronary artery bypass grafting or heart valve surgery. Material and methods. The study included 46 patients (median age 60.0 [53.0; 64.0] years) who underwent cardiac surgery. In 5 days after surgery, application with a personalized program of remote rehabilitation was installed in patients’ smartphones. This program included walking, exercises, diet and psychological control for 4 months. After this period, we analyzed participation of patients in remote rehabilitation program. In 6 months after surgery, we analyzed the adherence to the recommended medication and non-medication treatment by telephone survey. Results. Thirty-four (74%) out of 46 patients used a mobile application for remote rehabilitation. Of these, 24 (52%) ones used the section «Dosed walking» and «Therapeutic exercises» at least 5 times a week (adherent patients), 10 (22%) ones used the app irregular (8 times throughout 4 months on the average) and 12 (26%) patients did not engage in remote rehabilitation using the app (non-adherent patients). Non-adherent patients significantly more often continued smoking (41% vs. 12.5%), less often engaged in aerobic physical training (50% vs. 96%) and took medication recommended at discharge by the 6th month after surgery (81.8% vs. 100%) (p<0.05). Conclusion. Adherence of patients after cardiac surgery to remote rehabilitation was associated with higher adherence to medication and non-medication guidelines recommended at discharge. At the same time, adherence to remote rehabilitation program using a mobile application was insufficient (52%). It is required to develop and implement measures to increase motivation of patients to participate in long-term cardiac rehabilitation programs.