The Remote Exercise Monitoring Trial for Exercise-Based Cardiac Rehabilitation (REMOTE-CR): a Randomised Controlled Trial Protocol
BMC Public Health Nov 2014; 14:1236. DOI:10.1186/1471-2458-14-1236View abstract
BACKGROUND: Exercise is an essential component of contemporary cardiac rehabilitation programs for the secondary prevention of coronary heart disease. Despite the benefits associated with regular exercise, adherence with supervised exercise-based cardiac rehabilitation remains low. Increasingly powerful mobile technologies, such as smartphones and wireless physiological sensors, may extend the capability of exercise-based cardiac rehabilitation by enabling real-time exercise monitoring for those with coronary heart disease. This study compares the effectiveness of technology-assisted, home-based, remote monitored exercise-based cardiac rehabilitation (REMOTE) to standard supervised exercise-based cardiac rehabilitation in New Zealand adults with a diagnosis of coronary heart disease.
METHODS/DESIGN: A two-arm, parallel, non-inferiority, randomised controlled trial will be conducted at two sites in New Zealand. One hundred and sixty two participants will be randomised at a 1:1 ratio to receive a 12-week program of technology-assisted, home-based, remote monitored exercise-based cardiac rehabilitation (intervention), or an 8-12 program of standard supervised exercise-based cardiac rehabilitation (control).
The primary outcome is post-treatment maximal oxygen uptake (V̇O2max). Secondary outcomes include cardiovascular risk factors (blood lipid and glucose concentrations, blood pressure, anthropometry), self-efficacy, intentions and motivation to be active, objectively measured physical activity, self-reported leisure time exercise and health-related quality of life. Cost information will also be collected to compare the two modes of delivery. All outcomes are assessed at baseline, post-treatment, and 6 months, except for V̇O2max, blood lipid and glucose concentrations, which are assessed at baseline and post-treatment only.
DISCUSSION: This novel study will compare the effectiveness of technology-supported exercise-based cardiac rehabilitation to a traditional supervised approach. If the REMOTE program proves to be as effective as traditional cardiac rehabilitation, it has potential to augment current practice by increasing access for those who cannot utilise existing services.
Implementing an Electronic Clinical Activity Capture System for a Hospital Pharmacy Department - a Case Report in New Zealand
Ng, J (2009)
Health Care and Informatics Review Online 13(3):16-26View abstract
AIM: To implement an electronic clinical activity capture system for a hospital clinical pharmacy department.
INTRODUCTION: organisations Health service departments are increasingly being held accountable for providing high quality, efficient yet cost effective care. In order to do this, there must be robust information systems in place to capture relevant and measurable data on service workflow and activities.
CASE REPORT: This case report discusses the implementation process of such a system at the Middlemore Hospital Clinical Pharmacy Department from the period of January 2008 through to July 2009, highlighting key steps and barriers during this process. Selected examples of data and reports produced are also described showing the types of information that can be generated for the purpose of quality improvement and administration.
DISCUSSION: Implementation of a new electronic clinical activity capture system requires a multifaceted approach which must address legal, privacy, security, technological and human factors. This case report describes key steps in the implementation process and may help other departments which are undergoing such processes.