Despite strong evidence on the effectiveness of cardiac rehabilitation (CR) in secondary prevention, program implementation and referral rates across Europe are still low and patients’ nonadherence to central CR components over the continuum of the disease limit long-term benefits. In particular, patients with low health literacy, advanced age or multiple comorbidities often display high nonadherence rates to CR programs, with related need for a targeted intervention. In TIMELY, patient motivation, self-efficacy, and engagement leading to activation are considered the most important predictors of long-lasting lifestyle changes. Thus, improvement of patient activation and health literacy are central outcomes of the TIMELY intervention which will be assessed in a multicenter randomized controlled trial.
In TIMELY, secondary prevention will be supported using an artificial intelligence (AI) eHealth platform to improve the long-term benefits of CR. The central TIMELY components are guideline-based and aim to identify the best timepoint for (and type of) actions to provide coordinated and tailored interventions by considering the combination of medical treatment, structured exercise, overall lifestyle modification, and psychosocial impact. Based on the evidence on the importance of psychosocial factors for CR success, the TIMELY approach will be first to integrate repeated AI-based assessment of psychosocial risk factors and provide options to overcome individual barriers. On the individual level, TIMELY will help to manage cardiovascular risk factors, improve cardiopulmonary fitness, support a healthy lifestyle and improve health-related quality of life (QoL). TIMELY holds potential to lower the direct impact of coronary artery disease (CAD) on the health care system by reducing recurrent events and hospital readmission rates and will provide a platform for efficient collaboration between clinicians. TIMELY may reduce the burden to the wider society through lowering of comorbidity rates and better management of healthcare resources as well as by increasing productivity and workability.
TIMELY aims to further reduce cardiovascular morbidity and mortality by increasing overall CR uptake and by fully integrating CR-based secondary prevention. Despite a class IA indication in clinical guidelines, integration, referral, and uptake of CR remains low in Europe. Integration of the patients’ perspective and tailoring of the programs based on patients’ preference is one of the cornerstones of the TIMELY program and may help to increase uptake. Reduced cost for health care providers may allow to provide incentives to cardiologists for prescribing long-term CR programs. By 2024, TIMELY can be a certified eHealth solution for CR, i.e. a novel care pathway for patients with CAD.
TIMELY aligns with the Communication on Digital Transformation of Health and Care in the Digital Single Market priorities: