A randomized study of home-based training intervention with telemonitoring guidance in coronary artery disease patients - (TRiCH) Study

Avila, A, Claes, J, Goetschalckx, K, Buys, R, Azzawi, M, Vanhees, L and Cornelissen, V (2018) A randomized study of home-based training intervention with telemonitoring guidance in coronary artery disease patients - (TRiCH) Study. Journal of Medical Internet Research, 20 (6). e225. ISSN 1438-8871

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Abstract

Background: Cardiac rehabilitation (CR) is an essential part of coronary heart disease (CHD) management. However, patients exiting a center-based CR program have difficulty retaining its benefits. Objective: The purpose of the TRiCH study is to evaluate the added benefit of a home-based (HB) CR program with telemonitoring guidance on physical fitness in patients with coronary artery disease (CAD) who are being discharged from a phase II ambulatory CR program, and to compare its effectiveness to a prolonged center-based (CB) CR intervention. Methods: Between February 2014 and August 2016, 90 CAD patients (61.2±7.6yrs, 89% males, 1.73±0.7m, 82.9±13kg, 27.5±3.4kg/m2) who successfully completed a three month ambulatory CR program were randomly allocated to one of three groups: HB (=30), CB (=30) or a control group (CG) (=30) on a 1:1:1 basis. HB patients received a home-based exercise intervention with telemonitoring guidance consisting of weekly emails or phone calls, CB patients continued the ambulatory-hospital CR and CG patients received usual care including the recommendation to remain physically active. All patients underwent cardiopulmonary exercise testing to assess peak oxygen uptake (VO2P) at baseline and after the 12 week intervention period. Secondary outcomes included physical activity behavior, anthropometric characteristics, cardiovascular risk factors and quality of life. Results: The increase in VO2P was larger following 12 weeks of intervention in the CB group (P = .03) and HB group (P = .04) compared to the control group. In addition, oxygen uptake at the first ventilatory threshold (P-interaction = .03) and the second ventilatory threshold (P-interaction = .03) increased significantly more in the HB group compared to CB. No significant changes were found in the secondary outcomes. Conclusions: Adding a HB exercise program with telemonitoring guidance following completion of a phase II ambulatory CR program results in further improvement of physical fitness and is as equally effective as prolonging a CB CR in patients with coronary artery disease.