Skip to main content

The SharedHeart Approach: Technology-Supported Shared Decision Making to Increase Physical Activity in Cardiac Patients

  • Conference paper
  • First Online:
Pervasive Computing Technologies for Healthcare (PH 2021)

Abstract

After a cardiac event, patients typically enroll in a cardiac rehabilitation program in a rehabilitation center, where physiotherapists guide them in overcoming their fear to move and increasing physical activity. Effectively changing patients’ health behaviour and bringing the newly formed habits to their home environment remains challenging. At home, patients experience difficulties interpreting exercise targets and monitoring physical activity. To bridge the gap between supervised rehab in the center and regular exercise in daily life, we propose a shared decision making (SDM) approach SharedHeart that supports patients in changing their health behaviour and transferring the knowledge and healthy habits to their homes. We developed 3 applications that support patients and physiotherapists in following a SDM approach: (1) a tablet app to record the patient’s sports preferences, (2) a caregiver dashboard to create and follow up on a patient-tailored exercise plan during and in between SDM encounters, and (3) a mobile app to report and follow up on physical activity at home. In this paper, we present the results of our survey investigating physiotherapists’ application of SDM in their current practice and perceived usefulness of SDM and supporting tools. Next, we discuss our proposed SDM approach on the conceptual level and the guideline-based design of the supporting IT applications. We conclude by highlighting how our approach and tools align with physiotherapists’ needs.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Ainsworth, B.E., et al.: 2011 compendium of physical activities: a second update of codes and met values. Med. Sci. Sports Exerc. 43(8), 1575–1581 (2011)

    Article  Google Scholar 

  2. Authors/Task Force Members, Steg, P.G., James, S.K., Atar, D., Badano, L.P., et al.: ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). Eur. Heart J. 33(20), 2569–2619 (2012). https://doi.org/10.1093/eurheartj/ehs215

  3. Ayabe, M., et al.: The physical activity patterns of cardiac rehabilitation program participants. J. Cardiopulm. Rehabil. Prev. 24(2), 80–86 (2004)

    Article  Google Scholar 

  4. Batalik, L., Filakova, K., Batalikova, K., Dosbaba, F.: Remotely monitored telerehabilitation for cardiac patients: a review of the current situation. World J. Clin. Cases 8(10), 1818 (2020)

    Article  Google Scholar 

  5. Bonneux, C., Rovelo, G., Dendale, P., Coninx, K.: A comprehensive approach to decision aids supporting shared decision making in cardiac rehabilitation. In: Proceedings of the 13th EAI International Conference on Pervasive Computing Technologies for Healthcare, pp. 389–398. ACM (2019)

    Google Scholar 

  6. Bonneux, C., Ruiz, G.R., Dendale, P., Coninx, K.: Theory-informed design guidelines for shared decision making tools for health behaviour change. In: Ali, R., Lugrin, B., Charles, F. (eds.) PERSUASIVE 2021. LNCS, vol. 12684, pp. 259–274. Springer, Cham (2021). https://doi.org/10.1007/978-3-030-79460-6_21

    Chapter  Google Scholar 

  7. Couët, N., et al.: Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the option instrument. Health Expect. 18(4), 542–561 (2015)

    Article  Google Scholar 

  8. De Bacquer, D., et al.: EUROASPIRE IV and V surveys of the European observational research programme of the European society of cardiology: poor adherence to lifestyle recommendations in patients with coronary heart disease: results from the EUROASPIRE surveys. Eur. J. Prev. Cardiol. (2021). https://doi.org/10.1093/eurjpc/zwab115

  9. Dierckx, K., Deveugele, M., Roosen, P., Devisch, I.: Implementation of shared decision making in physical therapy: observed level of involvement and patient preference. Phys. Ther. 93(10), 1321–1330 (2013). https://doi.org/10.2522/ptj.20120286

    Article  Google Scholar 

  10. Dinesen, B., et al.: Personalized telehealth in the future: a global research agenda. J. Med. Internet Res. 18(3), e53 (2016). https://doi.org/10.2196/jmir.5257

  11. Frederix, I., Vanhees, L., Dendale, P., Goetschalckx, K.: A review of telerehabilitation for cardiac patients. J. Telemed. Telecare 21(1), 45–53 (2015). https://doi.org/10.1177/1357633X14562732

    Article  Google Scholar 

  12. Hansen, D., Coninx, K., Dendale, P.: The eapc expert tool. Eur. Heart J. 38(30), 2318–2320 (2017). https://doi.org/10.1093/eurheartj/ehx396

    Article  Google Scholar 

  13. Hansen, D., et al.: The European association of preventive cardiology exercise prescription in everyday practice and rehabilitative training (EXPERT) tool: a digital training and decision support system for optimized exercise prescription in cardiovascular disease. Eur. J. Prevent. Cardiol. 24(10), 1017–1031 (2017). https://doi.org/10.1177/2047487317702042

    Article  Google Scholar 

  14. Henselmans, I., Heijmans, M., Rademakers, J., van Dulmen, S.: Participation of chronic patients in medical consultations: patients’ perceived efficacy, barriers and interest in support. Health Expect. 18(6), 2375–2388 (2015)

    Article  Google Scholar 

  15. Joosten, E.A.G., Defuentes-merillas, L., De Weert, G., Sensky, T., Van Der Staak, C., De Jong, C.: Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother. Psychosomat. 77(4), 219–26 (2008)

    Article  Google Scholar 

  16. Joseph-Williams, N., Elwyn, G., Edwards, A.: Knowledge is not power for patients: a systematic review and thematic synthesis of patient-reported barriers and facilitators to shared decision making. Patient Educ. Couns. 94(3), 291–309 (2014). https://doi.org/10.1016/j.pec.2013.10.031

    Article  Google Scholar 

  17. Klasnja, P., Consolvo, S., McDonald, D.W., Landay, J.A., Pratt, W.: Using mobile & personal sensing technologies to support health behavior change in everyday life: lessons learned. In: AMIA Annual Symposium Proceedings, vol. 2009, p. 338. American Medical Informatics Association (2009)

    Google Scholar 

  18. Kon, A.A.: The shared decision-making continuum. Jama 304(8), 903–904 (2010). https://doi.org/10.1001/jama.2010.1208

    Article  Google Scholar 

  19. Mampuya, W.M.: Cardiac rehabilitation past, present and future: an overview. Cardiovasc. Diagn. Ther. 2(1), 38–49 (2012). https://doi.org/10.3978/j.issn.2223-3652.2012.01.02

    Article  Google Scholar 

  20. Moore, S.M., Kramer, F.M.: Women’s and men’s preferences for cardiac rehabilitation program features. J. Cardiopulm. Rehabil. Prev. 16(3), 163–168 (1996)

    Article  Google Scholar 

  21. Neubeck, L., Freedman, S.B., Clark, A.M., Briffa, T., Bauman, A., Redfern, J.: Participating in cardiac rehabilitation: a systematic review and meta-synthesis of qualitative data. Eur. J. Prev. Cardiol. 19(3), 494–503 (2012). https://doi.org/10.1177/1741826711409326

    Article  Google Scholar 

  22. Piepoli, M.F., et al.: Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European association for cardiovascular prevention & rehabilitation. Endorsed by the committee for practice guidelines of the European society of cardiology. Eur. J. Prev. Cardiol. 21(6), 664–681 (2014). https://doi.org/10.1177/2047487312449597

    Article  Google Scholar 

  23. Roffi, M., et al.: 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task Force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European society of cardiology (ESC). Eur. Heart J. 37(3), 267–315 (2016). https://doi.org/10.1093/eurheartj/ehv320

    Article  Google Scholar 

  24. Sankaran, S., Luyten, K., Hansen, D., Dendale, P., Coninx, K.: Have you met your mets?: enhancing patient motivation to achieve physical activity targets in cardiac tele-rehabilitation. In: Proceedings of the 32Nd International BCS Human Computer Interaction Conference, HCI 2018, pp. 48:1–48:12. BCS Learning & Development Ltd., Swindon (2018). https://doi.org/10.14236/ewic/HCI2018.48

  25. Smith, S.C., et al.: AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update. Circulation 124(22), 2458–2473 (2011). https://doi.org/10.1161/CIR.0b013e318235eb4d

    Article  Google Scholar 

  26. Stevenson, T.G., Riggin, K., Nagelkirk, P.R., Hargens, T.A., Strath, S.J., Kaminsky, L.A.: Physical activity habits of cardiac patients participating in an early outpatient rehabilitation program. J. Cardiopulm. Rehabil. Prev. 29(5), 299–303 (2009)

    Article  Google Scholar 

  27. Stiggelbout, A.M., et al.: Shared decision making: really putting patients at the centre of healthcare. BMJ 344, 28–31 (2012). https://doi.org/10.1136/bmj.e256

    Article  Google Scholar 

  28. Task Force Members, Montalescot, G., Sechtem, U., Achenbach, S., Andreotti, F., et al.: 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology. Eur. Heart J. 34(38), 2949–3003 (2013). https://doi.org/10.1093/eurheartj/eht296

  29. Vanhees, L., et al.: Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (part II). Eur. J. Prev. Cardiol. 19(5), 1005–1033 (2012)

    Article  Google Scholar 

Download references

Acknowledgements

This research was funded by the Special Research Fund (BOF) of Hasselt University (BOF18DOC26), FWO-ICA project EXPERT network (G0F4220N) and the EU funded project H2020 IA CoroPrevention (848056).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cindel Bonneux .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Bonneux, C., Hansen, D., Dendale, P., Coninx, K. (2022). The SharedHeart Approach: Technology-Supported Shared Decision Making to Increase Physical Activity in Cardiac Patients. In: Lewy, H., Barkan, R. (eds) Pervasive Computing Technologies for Healthcare. PH 2021. Lecture Notes of the Institute for Computer Sciences, Social Informatics and Telecommunications Engineering, vol 431. Springer, Cham. https://doi.org/10.1007/978-3-030-99194-4_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-99194-4_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-99193-7

  • Online ISBN: 978-3-030-99194-4

  • eBook Packages: Computer ScienceComputer Science (R0)

Publish with us

Policies and ethics