Heart attack and heart surgery patients who live in rural B.C. communities may soon have access to critical cardiac rehabilitation sessions without the need to travel, thanks to research underway at Vancouver General Hospital.
The hospital is in the midst of a study looking at a virtual cardiac rehab program, with the goal of one day expanding it across the province.
“These are typically patients who have been at Vancouver General Hospital or surrounding hospitals, and they’ve had their acute cardiovascular event, and then after that happens, they get referred to cardiac rehabilitation to help optimize their health to prevent second events from happening,” explained cardiologist and lead researcher Dr. Nate Moulson.
“What we noticed early on is that there’s a lack of access to centre-based programmes like we have here … and so we’ve always been looking at different modalities of delivering care and so virtual kind of meshes nicely with this and so the goal is to provide a similar standard of care over virtual means.”
Following a cardiac event, the rehab process involves four main components: education and counselling, nutritional therapy, medical optimization and exercise therapy.
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The study is focusing on that last component, which involves prescribing specific exercise doses tailored to an individual’s case and risk factors in order to help them reach the best health outcome.
Because of the elevated risk factors, that means the patients need to be monitored in real time.
Thanks to live video technology like Zoom, the VGH team is able to hold live, virtual exercise classes with participants — while monitoring them for safety in real time.
“I am totally impressed with the focus on safety in how we are … monitored, they just keep their eye on you pretty closely to make sure that nothing goes amiss,” study participant Frank Mackleston, who was treated for blockages in his coronary arteries, told Global News.
“I think there’s about, maybe up to 10 of us in the class, and she keeps a good eye on us, and you hear her mention her name, and maybe you need to sit down or maybe you need to take a few deep breaths.”
Cardiac patient Carol Boothroyd added that the virtual visits make the process far more convenient.
“You can do it at your dining room table, you don’t have to get in your car, fight traffic and pay for parking and be embarrassed in a gym, you can be embarrassed in your kitchen,” she said.
VGH actually launched its virtual rehab program out of necessity in the early stages of the COVID-19 pandemic.
The team is now well-practiced at administering the online component, which also includes virtual appointments with doctors and other specialists, as well as virtual group education sessions.
The research now is focusing on whether virtual care is as safe and effective as treatment delivered in person, and how it can best be expanded for people who don’t have similar resources in their communities.
“What’s novel and interesting is that we’re actually looking at how do we deliver this care for patients that live in rural and remote areas that have come down to Vancouver General Hospital to receive acute cardiovascular care or for consultations,” Moulson explained.
“We’re working on allowing them to receive the same standard of care just delivered virtually.”
The study is also looking at patient recruitment and engagement, and assessing completion and adherence rates, data collection methods, and patient access, autonomy, and satisfaction.
The work is being funded by the VGH and UBC Hospital Foundation and the Hometown Heroes Lottery. Researchers are hoping to have results within the next 12 months.
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