Abstract 14769: Outcomes of a Smartphone-based Application With Live Health-coaching Post-percutaneous Coronary Intervention

• Published in: Circulation (New York, N.Y.) N.Y.), 2020-11, Vol.142 (Suppl_3 Suppl 3), p.A14769-A14769
• Main Authors: Paruchuri, Kaavya, Finneran, Phoebe, Marston, Nicholas A, Healy, Emma W, Andreo, John, Lynch, Ryan, Blood, Alexander, Jones-O'Connor, Maeve, Lander, Bradley, Kelly, Noreen, Vivaldi, Maria T, Traynor, Kate, Wiviott, Stephen D, Natarajan, Pradeep
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.14769

IntroductionThe period between inpatient hospitalization for symptomatic CAD and post-discharge office consultation remains a vulnerable interval for adverse outcomes. Tools to help guide patients during this susceptible time are needed. MethodsWe customized content on a digital health platform for hospitalized patients receiving PCI which included education, tracking, reminders and health coaches. We conducted a single-arm open-label pilot study of the application (app) to test feasibility and efficacy at two academic medical centers with 1:3 propensity-matched historical controls (NCT03416920). We assessed whether the app led to excess 30-day hospital readmission, improved outpatient cardiovascular follow up (CVFU) and increased cardiac rehabilitation (CR) enrollment in our health system (MGB). Differences were assessed by Cox Proportional Hazards model. Results118 of 324 eligible (36.4%) were enrolled during incident PCI admission 02/18-06/19. 68 of 118 (57.6%) underwent PCI for MI. Mean age was 62.4 (9.7) years, 87 (73.7%) were male, 40 (33.9%) had DM2, and 59 (50.0%) had previously known CAD. There was no significant difference in all-cause readmission within 30 or 90 days. However, rates of both 90-day CR enrollment and 1-month CVFU were increased. App engagement was high – mean 47% daily and 63% weekly engagement within the first 90 days. Spearman correlation analyses indicated similar engagement across age, sex, and cardiovascular risk factors. ConclusionsA post-PCI smartphone app, with live health coaches, deployed upon discharge is feasible with similar engagement across demographics. Compared to historical controls, use of the app did not affect short-term hospital readmission but was associated with two-fold increased attendance in CR. Prospective randomized controlled trials are necessary to test the hypothesis that this digital health platform post-PCI improves cardiovascular outcomes over longer follow-up.