Table 2.
Overview of the patient assessment in CR and options for remote patient assessment in telerehabilitation, if initial face-to-face visit is not possible.
| Components | Patient assessment | Centre-based CR | Remote patient assessment |
|---|---|---|---|
| Clinical history | Cardiovascular risk factors | EMR + Multidisciplinary face-to-face intake consultation |
EMR + Telephone or video intake consultation with MD or case nurse |
| Comorbidities | |||
| Disabilities | |||
| Symptoms | Cardiovascular disease | Multidisciplinary face-to-face intake consultation | Telephone or video intake consultation with MD or case nurse |
| Adherence | Medication | EMR + Multidisciplinaryface-to-face intake consultation |
EMR + Telephone or video intake consultation with MD or case nurse |
| Self-monitoring | Multidisciplinary face-to-face intake consultation | Telephone or video intake consultation with MD or case nurse | |
| Lifestyle | |||
| Physical examination | Cardiovascular | Multidisciplinary face-to-face intake consultation | Recent consultation (EMR) + Video consultation for neurologic and orthopaedic tests + Self-monitoring weight, heart rate and BP |
| Neurologic | |||
| Orthopaedic | |||
| Electrocardiogram | Heart rate, repolarisation changes, heart rhythm | Resting ECG at start of centre-based CR programme | Recent ECG (EMR) Handheld single-lead ECG Smartwatch measured heart rhythm |
| Cardiac imaging | Echocardiography | Last echocardiography | Last echocardiography |
| Blood testing | Lipid values | Last blood test during hospitalisation or new blood test at start of centre-based CR programme | New blood test at general practitioner or last blood test during hospitalisation |
| Renal function | |||
| Glucose levels | |||
| Routine biochemical assay | |||
| Physical activity level | Barriers and social support | Intake face-to-face consultation with physiotherapist e.g. RAPA questionnaire108 |
Telephone or video intake consultation with physiotherapist e.g. TAPA questionnaire109 IPAQ110 |
| Domestic, occupational and recreational level | |||
| Self-confidence + readiness for behaviour change | |||
| Frailty | Frailty | Multidisciplinary face-to-face intake consultation Frailty questionnaire e.g. fried frailty index111 SPPB112 MNA-SF113 Timed up-and-go test114 FRAIL115 |
Telephone or video intake consultation with case nurse + e.g. MNA-SF113 FRAIL115 |
| Peak exercise testing | Exercise capacity | CPET 6MWT SPPB |
Safety decision by MD + e.g. Remote 6MWT Hunt study tool107 |
| Heart rate zones | |||
| Safety assessment | |||
| Education | Literacy level | Intake face-to-face consultation with psychologist e.g. HLS-EU-Q47116 HLQ117 |
Telephone or video intake consultation with psychologist e.g. HLS-EU-Q47116 HLQ117 |
| Patient rehabilitation goals | |||
| Psychosocial | Depression | Intake face-to-face consultation with psychologist e.g. PHQ-9118 BDI-II119 CAQ120 MSPSS121 |
Telephone or video intake consultation with psychologist e.g. PHQ-9118 BDI-II119 CAQ120 MSPSS121 |
| Anxiety | |||
| Social support | |||
| Vocational support |
EMR: electronic medical record; ECG: electrocardiogram; CPET: cardiopulmonary exercise testing; 6MWT: 6-minute walking test; SPPB: short physical performance battery; BP: blood pressure; MD: medical doctor; CR: cardiac rehabilitation; RAPA: rapid assessment of physical activity; TAPA: telephone assessment of physical activity; IPAQ: international physical activity questionnaire; MNA-SF: mini nutritional assessment; PHQ-9: patient health questionnaire-9; BDI-II: Beck depression inventory; CAQ: cardiac anxiety questionnaire; MSPSS: multidimensional scale of perceived social support.