Effectiveness and cost-effectiveness of a web-based cardiac rehabilitation programme for people with chronic stable angina: protocol for the ACTIVATE (Angina Controlled Trial Investigating the Value of the 'Activate your heart' Therapeutic E-intervention) randomised controlled trial.

Journal: BMJ open

Volume: 14

Issue: 3

Year of Publication: 2024

Affiliated Institutions:  Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK nefyn.williams@liverpool.ac.uk. Department of Public Health Policy and Systems, University of Liverpool, Liverpool, UK. Patient and Public Involvement, National Institute for Health and Care Research Applied Research Collaboration North West Coast, Liverpool, UK. Department of Health Data Science, University of Liverpool, Liverpool, UK. Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK. Liverpool Clinical Trials Centre, University of Liverpool, Liverpool, UK. Institute of Applied Health Research, University of Birmingham, Birmingham, UK. School of Nursing and Allied Health, Liverpool John Moores University, Liverpool, UK. Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Liverpool, UK. Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, UK. Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK. School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK. Department of Respiratory Sciences, University of Leicester, Leicester, UK.

Abstract summary 

Chronic stable angina is common and disabling. Cardiac rehabilitation is routinely offered to people following myocardial infarction or revascularisation procedures and has the potential to help people with chronic stable angina. However, there is insufficient evidence of effectiveness and cost-effectiveness for its routine use in this patient group. The objectives of this study are to compare the effectiveness and cost-effectiveness of the 'Activate Your Heart' cardiac rehabilitation programme for people with chronic stable angina compared with usual care.ACTIVATE is a multicentre, parallel-group, two-arm, superiority, pragmatic randomised controlled trial, with recruitment from primary and secondary care centres in England and Wales and a target sample size of 518 (1:1 allocation; allocation sequence by minimisation programme with built-in random element). The study uses secure web-based allocation concealment. The two treatments will be optimal usual care (control) and optimal usual care plus the 'Activate Your Heart' web-based cardiac rehabilitation programme (intervention). Outcome assessment and statistical analysis will be performed blinded; participants will be unblinded. Outcomes will be measured at baseline and at 6 and 12 months' follow-up. Primary outcome will be the UK version of Seattle Angina Questionnaire (SAQ-UK), physical limitations domain at 12 months' follow-up. Secondary outcomes will be the remaining two domains of SAQ-UK, dyspnoea, anxiety and depression, health utility, self-efficacy, physical activity and the incremental shuttle walk test. All safety events will be recorded, and serious adverse events assessed to determine whether they are related to the intervention and expected. Concurrent economic evaluation will be cost-utility analysis from health service perspective. An embedded process evaluation will determine the mechanisms and processes that explain the implementation and impacts of the cardiac rehabilitation programme.North of Scotland National Health Service Research Ethics Committee approval, reference 21/NS/0115. Participants will provide written informed consent. Results will be disseminated by peer-reviewed publication.ISRCTN10054455.

Authors & Co-authors:  Williams Collins Comerford Dodd Fisher Hardwick Hennessy Jolly Jones Lane Lip Morgan Ralph Thijssen Singh

Study Outcome 

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Citations :  Eisen A, Bhatt DL, Steg PG, et al. . Angina and future cardiovascular events in stable patients with coronary artery disease: insights from the reduction of atherothrombosis for continued health (REACH) registry. J Am Heart Assoc 2016;5:e004080. 10.1161/JAHA.116.004080
Authors :  15
Identifiers
Doi : e084509
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Adult cardiology;HEALTH ECONOMICS;Ischaemic heart disease;Primary Care;REHABILITATION MEDICINE;Randomized Controlled Trial
Study Design
Study Approach
Country of Study
Publication Country
England