The objective of the AvanzaT application is to enable people to return to the most normal life possible after a cardiac event, while also helping them adapt to their new situation. It is a multidisciplinary programme that involves cardiologists, nurses and physiotherapists specialising in cardiac rehabilitation. It lasts 8 weeks, and includes three weekly group physical training sessions (strength and endurance). It also offers training in heart-healthy lifestyle habits, patient empowerment and basic cardiopulmonary resuscitation.
Other apps aimed at patients with heart disease offer general health advice and focus on a specific aspect, such as physical exercise or nutrition. This is the first platform with such comprehensive, multidisciplinary and personalised monitoring, specifically designed for patients with ischaemic heart disease. It has the added value of offering a holistic point of view that takes all aspects of the patient’s life into account, such as nutritional and emotional aspects.
What’s more, it allows those close to the patient to be involved in their lifestyle change, as the family is encouraged to participate in sessions. In the case of patients with specific needs, the programme also offers personalised guidance through individual video calls, such as in the case of patients who have difficulty adhering to the Mediterranean diet and suffer from obesity.
Patients begin the programme one month after their heart attack or ischaemic event. They have the app on their mobile phone and healthcare professionals can monitor their progress via the online platform. The programme is carried out almost entirely remotely. Patients only go to the hospital for the initial visit, to confirm that the physical training is suitable for them, and to obtain data that allows exercise to be prescribed on an individual basis. At the end of the programme, the benefits obtained are evaluated and the patient is given the tools necessary to maintain them throughout their life.
The need to develop this type of programme was identified by professionals working at Hospital Clínic’s Cardiology Department. There were other rehabilitation programmes at the hospital for patients with heart failure or heart surgery patients, but there was nothing specifically for patients who had suffered a heart attack. This lack, combined with the need for remote care caused by the pandemic, highlighted the demand for this kind of programme. The funds donated by the company Ferrer and the technological development of HumanITCare meant the AvanzaT App could become a reality.
The programme has been active since last January and, of the 30 patients who have been included so far, 11 have completed it with very positive preliminary results. They have improved their aerobic functional capacity, muscle strength and adherence to the Mediterranean diet, while symptoms of anxiety and depression decreased; therefore, their quality of life has increased. Adherence to the training and educational sessions was excellent (over 80%) with a high degree of satisfaction among patients and professionals.
Thanks to this platform, possibilities for patient participation have expanded, as they are not limited by the physical space required or the capacity (conditions which are further restricted by the pandemic). The other pre-existing cardiac rehabilitation programmes at the hospital have also undergone a digital transformation to create remote versions, as necessitated by the pandemic.
Information documented by: Dr María Sanz, Cardiology Department at Hospital Clínic de Barcelona