The role of Blended Learning in Enhancing Self-Efficacy and Medication Adherence in Cardiac Rehabilitation for Patients Undergoing Coronary Artery Bypass Surgery: A Randomised Control Trial: Blended learning in cardiac rehabilitation.

Abstract

Objective: This study aimed to evaluate the effectiveness of a traditional cardiac rehabilitation (CR) program compared to an augmented program that integrates traditional cardiac rehabilitation with face-to-face training sessions and remote assistance facilitated through an application based on the Knowledge, Attitude, and Practice (KAP) model for individuals undergoing coronary artery bypass graft (CABG) surgery.

Design: A randomized controlled trial with a blinded outcome assessment was used (IRCT20230902059333N1).

Setting: A major heart center in a middle-income country.

Participants: Of the 80 patients referred to the cardiac rehabilitation program during the study, 70 patients were successfully enrolled, reaching the target sample size. Participants were randomly assigned in a 1:1 ratio, resulting in 35 patients per group.

Intervention: In addition to traditional cardiac rehabilitation, patients participated in four in-person training sessions throughout the rehabilitation process and received three months of follow-up support via the app after completing the program.

Main outcome measures: Medication adherence and self-efficacy were assessed before the initiation of cardiac rehabilitation (CR), immediately following the completion of CR, and three months post-completion of CR.

Results: There were no significant demographic differences between the intervention and control groups. However, throughout the study, significant differences emerged in favor of the 3 group concerning medication adherence and self-efficacy (p<0.001). The intervention group showed substantial and continuous improvements in medication adherence and self-efficacy scores, which were evident from the first month and persisted over time.

Conclusion: Implementing a blended learning approach in cardiac rehabilitation has demonstrated benefits in medication adherence and self-efficacy, highlighting the necessity for further research and clinical application.