Preferences of frail elderly patients with cardiovascular disease for web-based exercise telerehabilitation interventions in China: protocol for a discrete choice experiment study.

Abstract

Individuals with cardiovascular disease are prone to frailty, while frailty accelerates disease progression and worsens outcomes. Exercise interventions are essential non-pharmacological treatments for frail elderly patients with cardiovascular disease; however adherence remains low and strategies are inconsistent. Telerehabilitation improves accessibility, allows continuous monitoring with timely clinical responses and helps overcome mobility and geographical barriers for frail older adults. Guided by the patient-centred approach, exercise telerehabilitation should consider both clinical effectiveness and patient preferences to enhance acceptance and adherence. However, patient preferences for web-based exercise telerehabilitation remain poorly understood. This study is designed as a discrete choice experiment to elicit and quantify preferences for key features of web-based exercise telerehabilitation among frail older adults with cardiovascular disease. Candidate attributes and levels were developed through a systematic literature review, patient focus groups and expert consultation. An orthogonal fractional-factorial design will generate the choice sets. A questionnaire survey will recruit older adults with cardiovascular disease who are identified as frail based on validated frailty assessment scales. Participants will be recruited from a cardiovascular specialty hospital in Xiamen, China, with a planned sample size of 157. Final data will be analysed using mixed logit models to estimate attribute importance, quantify preference weights and identify preference heterogeneity. This study has received ethical approval from the relevant institutional ethics committee (2025-46). All participants will provide informed consent. Findings will be disseminated to patient groups, clinicians and policymakers and published in peer-reviewed journals and presented at national and international conferences.