Assessment of the Bangla Heart Manual in patients with coronary heart disease and their caregivers in Bangladesh: a feasibility study

Objectives To assess the feasibility and acceptability of the home-based Bangla Heart Manual of Cardiac Rehabilitation (CR) programme for people with coronary heart disease (CHD) following revascularisation living in Bangladesh. Design and settings Tertiary level cardiac hospital in Dhaka city; a single-centre feasibility pilot study, with a mixed-methods single arm pre–post design. Participants The study involved 33 patients with CHD admitted for revascularisation (coronary artery bypass graft or percutaneous coronary intervention) between June and July 2024, selected from 72 screened. Two physiotherapists and one nurse conducted the research, focusing on patients deemed suitable for CR. Intervention Selected patients received the Bangla Heart Manual intervention that consisted of a 6-week programme of home-based CR including exercise training, self-care, relaxation, risk factor management and psychological support facilitated by a healthcare professional. Primary and secondary outcomes The primary outcomes focused on feasibility, assessing patient recruitment, retention and adherence to the intervention using quantitative and qualitative methods, including interviews with patients, caregivers and healthcare professionals. Secondary outcomes measured patient-reported metrics like health-related quality of life (HeartQoL, EQ-5D-5L), psychological well-being, exercise capacity (Hospital Anxiety and Depression Scale), and serious adverse events (hospitalisation and mortality) before and after the Bangla Heart Manual intervention. Results The 33 patients recruited included 29 (88%) males with a mean age of 55 years. The following feasibility outcomes were achieved: 46% (33 patients from 72 screened) recruited, 91% (30/33) retention (complete outcome data at follow-up) and 75% intervention adherence (≥6 sessions attended of 8 sessions). Improvements following CR participation were seen in patient-reported outcomes and exercise capacity. Two deaths and one rehospitalisation occurred during the study. Conclusions This study showed that the Bangla Heart Manual home-based CR programme was acceptable and feasible for people with CHD in Bangladesh and healthcare professional staff to deliver. Our results also support the feasibility of recruitment and data collection processes for a future multicentre randomised trial to formally test the clinical and cost effectiveness of the adapted Bangla Heart Manual. Trial registration number ISRCTN1545620 .