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Virtual doctors the future of B.C.’s heart health?

Instead of traveling hundreds of kilometers to see a heart specialist, British Columbians who live outside of Greater Vancouver will soon have the medical staff come to them. Over the Internet.

Announced this week, the Heart and Stroke Foundation commissioned a $284,000 study that will investigate the potential of supplying people in rural communities with virtual cardiac rehabilitation.

“Heart disease is still the leading cause of death in B.C. and in Canada,” said Scott Lear, a Simon Fraser University kinesiologist and the lead investigator of the study.

He said that the program could be a lifesaver for many rural British Columbians, pointing out that only 15 to 25 per cent of eligible patients attend cardiac rehab, even though these programs reduce the risk of death from heart disease by one quarter.

“People living outside these large areas don’t get access,” he said. Fewer Canadians live in rural areas, he added, but they have disproportionately higher cases of heart disease.

A pilot study in 2007 that investigated the feasibility and safety of online cardiac rehabilitation programs found all 15 participants in the virtual program improved their ability to exercise and saw reductions of cholesterol that were similar to the hospital-based program.

Traditional cardiac rehabilitation occurs in the hospital. It involves medially supervised exercise, consultations with dietitians, and prescription drug management.

In the virtual program, lasting three to four months, people are provided with blood pressure monitors and have online chat sessions with a nurse, an exercise specialist and a dietitian. They upload data from their exercise heart-rate monitor, as well as their blood pressure, weight and glucose levels.

The current expanded study is recruiting 74 patients from Prince George, Whistler, Squamish and the Sunshine Coast.

Christa Hammons is a study participant living in Whistler. When she had a heart intervention a few years ago she was given literature on rehabilitation and sent home.

“I did really well for the first five months,” Hammons told The Tyee. “But there was no one to talk to and no one who kept an eye on it and it sort of petered out.”

This time, she said, the virtual program is keeping her focused. She must upload the data from her daily exercises and this gives her an incentive to complete them. She also gets answers to any questions she has.

One thing the online program cannot recreate, however, is the peer-support a group of patients can provide, she said.

Researchers have tried to replicate this community online with a chat group, however, and Hammons listed the weekly chat group as another benefit of the program.

The full study into the rural implementation of such a program will not be completed for another two years. Participants will be monitored for a year after they complete the program to make sure the benefits are lasting.

The initiative has attracted the interest of health authorities and Lear said virtual cardiac rehab could be available to everyone in B.C. before the end of the study.

Melanie Kuxdorf reports for The Tyee.

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