SMARTphone-based, early cardiac REHABilitation in patients with acute coronary syndromes [SMART-REHAB Trial]: a randomized controlled trial protocol.
There are well-documented treatment gaps in secondary prevention of coronary heart disease and no clear guidelines to assist early physical activity after acute coronary syndromes (ACS). Smartphone technology may provide an innovative platform to close these gaps. This paper describes the study design of a randomized controlled trial assessing whether a smartphone-based secondary prevention program can facilitate early physical activity and improve cardiovascular health in patients with ACS.



We have developed a multi-faceted, patient-centred smartphone-based secondary prevention program emphasizing early physical activity with a graduated walking program initiated on discharge from ACS admission. The program incorporates; physical activity tracking through the smartphone's accelerometer with interactive feedback and goal setting; a dynamic dashboard to review and optimize cardiovascular risk factors; educational messages delivered twice weekly; a photographic food diary; pharmacotherapy review; and support through a short message service. The primary endpoint of the trial is change in exercise capacity, as measured by the change in six-minute walk test distance at 8-weeks when compared to baseline. Secondary endpoints include improvements in cardiovascular risk factor status, psychological well-being and quality of life, medication adherence, uptake of cardiac rehabilitation and re-hospitalizations.



This randomized controlled trial will use a smartphone-phone based secondary prevention program to emphasize early physical activity post-ACS. It will provide evidence regarding the feasibility and utility of this innovative platform in closing the treatment gaps in secondary prevention.



The trial was retrospectively registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) on April 4, 2016. The registration number is ACTRN12616000426482 .
Department of Cardiology, Austin Health, Melbourne, Australia. matiasyudi@gmail.com.|Department of Medicine, University of Melbourne, Melbourne, Australia. matiasyudi@gmail.com.
Matias B
MB
Yudi
Department of Cardiology, Austin Health, Melbourne, Australia.|Department of Medicine, University of Melbourne, Melbourne, Australia.
David J
DJ
Clark
Department of Cardiology, Western Health, Melbourne, Australia.
David
D
Tsang
Department of Medicine, University of Melbourne, Melbourne, Australia.|Department of Cardiology, St Vincent's Hospital, Melbourne, Australia.|Department of Heart and Mind, Australian Catholic University, Melbourne, Australia.
Michael
M
Jelinek
Department of Cardiology, Austin Health, Melbourne, Australia.
Katie
K
Kalten
Monash Heart, Monash Health, Melbourne, Australia.
Subodh
S
Joshi
Monash Heart, Monash Health, Melbourne, Australia.
Khoa
K
Phan
Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia.
Arthur
A
Nasis
Department of Cardiology, Barwon Health, Geelong, Australia.
John
J
Amerena
Department of Cardiology, St Vincent's Hospital, Melbourne, Australia.
Sandeep
S
Arunothayaraj
School of Public Health, Curtin University, Perth, Western Australia, Australia.
Chris
C
Reid
Department of Cardiology, Austin Health, Melbourne, Australia.|Department of Medicine, University of Melbourne, Melbourne, Australia.
Omar
O
Farouque
D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000517:prevention & control / Q000534:rehabilitation*; D000072038:Cardiac Rehabilitation / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005500:Follow-Up Studies; D006801:Humans; D010349:Patient Compliance; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D016037:Single-Blind Method; D000068997:Smartphone; D060145:Text Messaging; D016896:Treatment Outcome
Acute coronary syndromes; Cardiac rehabilitation; Secondary prevention; Smartphone application; mhealth