PATHway proposes a radically novel approach to Cardiac Rehabilitation (CR) that will ensure a paradigm shift towards empowering patients to more effectively self-manage their Cardiovascular Disease (CVD), set within a collaborative care context with health professionals. It has the potential to deliver significant cost savings to the healthcare system, and direct more appropriate utilization of healthcare resources. This will be achieved via a patient-centric holistic approach that specifically addresses the above barriers. PATHway will provide individualized rehabilitation programs that use regular, socially inclusive exercise sessions as the basis upon which to provide a personalized, comprehensive lifestyle intervention program (managing exercise/physical activity (PA), smoking, diet, stress management, alcohol use etc.) to enable patients to both better understand and deal with their own condition and to lead a healthier lifestyle in general. This will be made possible by the provision of an internet- enabled, sensor-based home exercise platform that allows remote participation in CR exercise programs at any time, either by one-self or by a small number of patients, from the comfort of their own living room.

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Cardiovascular disease collectively refers to diseases of the heart and circulatory system including coronary artery disease (CAD) and congenital heart disease (CHD). It is the leading cause of premature death (30% of all deaths) and disability in Europe and worldwide (WHO). With changing demographics and deteriorating lifestyle this situation will worsen considerably, which is neither economically or socially sustainable.

Cardiac Rehabilitation is a secondary prevention programme with exercise, which includes an educational programme on healthy lifestyle (dietary habits, smoking cessation, alcohol consumption and learning to manage stress).

There are generally three phases of CR:

  • Phase I is in-hospital education;
  • Phase II is very structured and begins after leaving hospital with out-patient return visits 2-3 times/week for supervised exercise training and education sessions;
  • Phase III requires the patient to self-manage their rehabilitation.

However, patient CR uptake and adherence are very low across member states, especially for phase III: approximately 11% of eligible patients begin a long-term phase III community-based CR programme.

PATHway will target individuals entering Phase III as this is where large numbers of patients, who would benefit significantly from exercise and CR, drop out.

Increased PA alone reduces all-cause mortality by 24% and provides considerable protection from cardiovascular risk factors and co-morbidities, leading to longer independent living and a lower use of health care resources.

Providing CR interventions in the home the patient is allowed to use at any time in a comfortable and personal environment PATHway system. In addition, there are clear benefits to all members of the health eco-system to move away from a healthcare provider-centric system to a co-production model, which empowering patients to self-manage their CVD has been shown to further enhance improvements in health and quality of life associated with a home-based CR programme.