Role of Blended Learning in Enhancing Self-Efficacy and Medication Adherence in Cardiac Rehabilitation for Individuals Undergoing Coronary Artery Bypass Surgery: A Randomized Control Trial.

Abstract

This study aimed to evaluate the effectiveness of a traditional cardiac rehabilitation (CR) program compared with an augmented program that integrates traditional CR with face-to-face training sessions and remote assistance facilitated through an application based on the knowledge, attitudes, and practices model for individuals undergoing coronary artery bypass graft (CABG) surgery. A randomized controlled trial with a blinded outcome assessment was used (IRCT20230902059333N1). A major heart center in a middle-income country. Of the 80 patients referred to the CR program during the study, 70 patients (N=70) were successfully enrolled, reaching the target sample size. Participants were randomly assigned in a 1:1 ratio, resulting in 35 patients per group. In addition to traditional CR, patients participated in 4 in-person training sessions throughout the rehabilitation process and received 3 months of follow-up support via the app after completing the program. Medication adherence and self-efficacy were assessed before the initiation of CR, immediately after its completion, and 3 months postcompletion. There were no significant demographic differences between the intervention and control groups. However, throughout the study, significant differences emerged in favor of the 3 groups concerning medication adherence and self-efficacy (P<.001). The intervention group showed substantial and continuous improvements in medication adherence and self-efficacy scores, which were evident from the 1st month and persisted over time. Implementing a blended learning approach in CR has demonstrated benefits in medication adherence and self-efficacy, highlighting the necessity for further research and clinical application.