Feasibility and efficacy of mobile app implementation among patients with acute myocardial infarction enrolled in coordinated cardiac rehabilitation program

Jan Harpula^1*Barbara Kalańska-Łukasik¹Grzegorz Głód²Piotr Gąsierkiewicz³Oliwia Barnaś¹Mateusz Danioł¹Piotr Godek¹Krystian Wita⁴Małgorzata Kowalska⁵Wojciech Wojakowski¹Tomasz Jadczyk^1,6

• ¹Department of Cardiology and Structural Heart Diseases, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
• ²Department of Entrepreneurship and Management Innovation, University of Economics in Katowice, Katowice, Poland
• ³AllBright Technologies sp. z o.o., Kraków, Poland
• ⁴I(st) Department of Cardiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
• ⁵Department of Epidemiology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Silesian, Poland
• ⁶Interventional Cardiac Electrophysiology Group, International Clinical Research Center, St. Anne's University Hospital, Brno, Czechia

Abstract Introduction: Cardiovascular diseases (CVD), notably acute myocardial infarction (AMI), persist as a leading cause of global mortality despite advances in clinical management. Coordinated cardiac rehabilitation (CR) programs, such as the Coordinated Patient Care Program after Myocardial Infarction (MC-AMI), have demonstrated substantial reductions in mortality rates. However, optimizing outpatient care within these programs remains a challenge due to increasing patient volumes and physician workloads. This issue could be alleviated by using technology. Leveraging telemedicine solutions, particularly mobile apps, presents a promising avenue for addressing these challenges. Aim: The main objectives of this study were to determine if the dedicated mobile app for the cardiac rehabilitation program optimizes outpatient visit workflow and improves patient adherence to the CR program. Patients and methods: This observational study enrolled 103 patients after AMI, who completed the CR program and were eligible for the outpatient follow-up. Patients were divided into two groups: (1) the active group (n=60) treated with a standard of care supplemented with the AHP-KOS app, and (2) the reference group (n=43) treated with standard care without the AHP-KOS app. The first outpatient CR visit occurred 6 weeks after AMI. Results: Implementation of the AHP-KOS app was associated with higher adherence to the CR program (91.7% of patients using the mobile app completed 6-week outpatient visits vs. 67.4% of individuals treated with standards of care, p<0.001). Additionally, the duration of onsite visits was significantly reduced in the active vs. reference group (8±3 min. vs. 11±4 min, p<0.001, respectively). Conclusions: The AHP-KOS mobile app implemented in post-AMI resulted in higher adherence to the CR program (MC-AMI). Furthermore, the application of the AHP-KOS app resulted in financial and workflow optimization allowing for a significantly shorter time of outpatient visits.