Lifestyle behaviour change of patients following cardiac rehabilitation: the BENEFIT intervention study with one-year follow-up

Aims: The majority of people with cardiovascular disease do not maintain a healthy lifestyle. To help patients implement behaviour change at home, the BENEFIT programme was developed as an addition to cardiac rehabilitation (CR) care.

Methods and results: Using a cluster non-randomized controlled trial design involving seven CR centres, we examined whether intervention group patients (n = 587) showed increased improvements in health behaviour change compared with control group patients (n = 298) who (only) received a multidisciplinary, comprehensive CR programme. Physical activity, smoking, alcohol use, diet, stress, and sleep were assessed at the start and after finishing CR (short-term) and at 1-year follow-up (long-term). Core of the intervention was access to an advanced eHealth platform consisting of functionality for daily goal monitoring, access to lifestyle interventions, personal coaching and a reward programme.

Findings: The standard CR programme improved most lifestyle behaviours, while the intervention led to additional short-term changes in vegetable intake (t = 2.00, P = 0.023), work-related stress (z = −2.97, P = 0.002), and sleep hours (t = 2.57, P = 0.005). Finally, in contrast to the control group (t = 1.88, P = 0.415), the intervention group significantly increased its physical activity long-term (t = 5.04, P <0.001) exercising 42 min more per week, yet this group-interaction effect showed only a trend (t = 1.55, P = 0.061).

Conclusion: While comprehensive CR care led to improvements in most lifestyle behaviours, the BENEFIT programme demonstrated additional benefits, particularly in physical exercise, dietary habits, stress reduction, and sleep, across a diverse CR-patient population. These findings underscore the potential of integrating eHealth solutions as an effective supplement to traditional CR care.