Behavioural and psychological telehealth support for people with cardiac conditions: randomized trial of the ‘back on track’ self-management programme

• Published in: European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology 2024-01, Vol.23 (1), p.42-54
• Main Authors: Rogerson, Michelle C, Jackson, Alun C, Navaratnam, Hema S, Le Grande, Michael R, Higgins, Rosemary O, Clarke, Joanne, Murphy, Barbara M
• Format: Article
• Language: English
• Subjects: Australia; Cardiovascular Diseases; Cognitive Behavioral Therapy - methods; Humans; Self-Management; Telemedicine
• ISSN: 1474-5151; 1873-1953
• DOI: 10.1093/eurjcn/zvad034

Abstract Aims Behaviour modification and mood management are essential to recovery after a cardiac event. Recent times have seen a major shift to remote delivery of cardiac services. This study assessed behavioural and psychological outcomes of the Back on Track online self-management programme, comparing the programme undertaken alone (self-directed) vs. with telephone support (supported). Relevance for people with depression was also assessed. Methods and results Participants with cardiac conditions (n = 122) were randomly assigned to self-directed or supported groups and given access to the online programme for 2 months. The programme addressed depression, anxiety, physical activity, and healthy eating. Supported group participants also received two telephone sessions facilitated by a trained counsellor to further enhance their self-management skills and engagement with the online modules. The Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Active Australia Survey and Diet Quality Tool were administered at baseline, 2, and 6 months. χ2 tests were used to compare self-directed and supported groups. Cochrane’s Q tests assessed changes over time in depression, anxiety, and physical activity (PA) and healthy diet guideline achievement. Participants in both groups showed reduced depression rates (self-directed, P < 0.05) and increased PA after programme completion (both groups, P < 0.05). Amongst those classified as depressed at baseline, significantly fewer were classified as depressed over time (P < 0.001) and significantly more were achieving the PA guidelines (P < 0.01) compared to those who were not depressed at baseline. Conclusions The Back on Track telehealth programme was effective in assisting with behavioural and emotional recovery after a cardiac event. The programme may be particularly beneficial for those who are depressed early in their recovery period. Trial Registration Australian New Zealand Clinical Trials Registry: ACTRN12620000102976. Graphical Abstract Graphical Abstract