Cardiac rehabilitation for people with chronic stable angina

INTERVENTION: People with long‐term stable angina will be recruited and divided into two groups. One group will receive usual care; the other group will undertake a rehabilitation programme in addition to usual care. Participants in undertaking the rehabilitation programme will be given access to ‘ActivateYourHeart’ (www.activateyourheart.org.uk). The programme is tailored to individual needs and is in four stages, which can be completed in 8 weeks, but access to the site and its features continue for 12 months. Participants will complete the intervention with support from cardiac rehabilitation staff. The online programme called ‘ActivateYourHeart’ has already been developed. It was designed to be used by many kinds of people with heart disease including those who cannot or do not want to attend group rehabilitation sessions. It can be used at home and can be completed at the participant’s own pace. An early preliminary study on people with stable angina indicates that it may be beneficial and that a larger trial is needed. People usually access this programme using their computer or their mobile device and the programme provides them with a tailored plan. However, before beginning the programme each participant receives face‐to‐face training using the website and a written user manual. A paper‐based version will also be available if people are not comfortable using the website. Before the start of the programme, participants will review the participant information sheet and provide written informed consent at their GP surgery and questionnaires will be used to measure physical limitations, the frequency and severity of chest pain, shortness of breath, quality of life, anxiety, depression, and the use of health services. Participants will complete CONDITION: Angina pectoris ; Circulatory System ; Chronic stable angina PRIMARY OUTCOME: Physical limitations measured using the UK Version of Seattle Angina Questionnaire (SAQ‐7) Physical Limitation domain at baseline, 6, and 12 months SECONDARY OUTCOME: ; 1. Dyspnea measured using the Rose Dyspnea Scale at baseline, 6, and 12 months; 2. Anxiety and depression measured using the Hospital Anxiety and Depression Scale (HADS) at baseline, 6, and 12 months; 3. Perceived self‐efficacy measured using the Generalised Self‐Efficacy scale at baseline, 6, and 12 months; 4. Physical activity measured with the ActivPAL accelerometer over 7 days at baseline, 6, and 12 months; 5. Health–related physical activity measured using the International Physical Activity Questionnaire (IPAQ) at baseline, 6, and 12 months; 6. Exercise capacity measured using the Incremental Shuttle Walk Test at baseline, 6, and 12 months; 7. Quality of life measured using the EuroQol 5‐Dimension 5‐Level Quality of Life questionnaire (EQ‐5D‐5L) at baseline, 6, and 12 months; 8. Service utilisation measured using the Client Service Receipt Inventory (CSRI) at baseline, 6, and 12 months; INCLUSION CRITERIA: 1. Aged =18 years 2. Chronic stable angina with at least 2 out of 3 of the following features: 2.1. Constricting central chest pain 2.2. Precipitated by exertion or emotional stress 2.3. Relieved by rest or glyceryl trinitrate spray 3. Documented coronary artery disease on angiography with =70% stenosis of coronary arteries based on invasive coronary angiography, computerised tomography angiography, or reversible myocardial ischaemia on myocardial perfusion testing 4. Revascularisation procedures not planned and treated with medical treatments only. Including people with previous MI, or previous revascularisation procedure who may have attended cardiac rehabilitation in the past.