The effects of Hartcoach, a life style intervention provided by telephone on the reduction of coronary risk factors: a randomised trial
Cardiovascular disease (CVD) is the leading cause of death worldwide. Secondary prevention is essential, but participation rates for cardiac rehabilitation are low. Furthermore, current programmes do not accomplish that patients with CVD change their lifestyle in a way that their individual risk factors for recurrent events decrease, therefore more effective interventions are needed. In this study, the effectiveness of the Hartcoach-programme, a telephonic secondary prevention program focussing on self management, is studied.
A multicenter, randomised parallel-group study is being conducted. Participants are 400 patients with acute myocardial infarction (STEMI, NSTEMI,) and patients with chronic or unstable angina pectoris (IAP). Patients are recruited through the participating hospitals and randomly assigned to the experimental group (Hartcoach-programme plus usual care) or the control group (usual care).
The Hartcoach-programme consists of a period of six months during which the coach contacts the patient every four to six weeks by telephone. Coaches train patients to take responsibility for the achievement and maintenance of the defined target levels for their particular individual modifiable risk factors. Target levels and treatment goals are agreed by the nurse and patient together. Data collection is blinded and occurs at baseline and after 26 weeks (post-intervention). Primary outcome is change in cardiovascular risk factors (cholesterol, body mass index, waist circumference, blood pressure, physical activity and diet). Secondary outcomes include chances in glucose, HbA1c, medication adherence, self-management and quality of life.
This study evaluates the effects of the Hartcoach-programme on the reduction of individual risk factors of patients with CVDs. Patients who are not invited to follow a hospital based rehabilitation programme or patients who are unable to adhere to such a programme, may be reached by this home based Hartcoach-programme. If positive results are found, the implementation of the Hartcoach-programme will be extended, having implications for the management of many people with CVD.
- Cardiovascular diseases (CVDs).
- Patel, AV, Bernstein, L, Deka, A, Feigelson, HS, Campbell, PT, Gapstur, SM (2010) Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol 172: pp. 419-429 CrossRef
- Graham, I, Atar, D, Borch-Johnsen, K, Boysen, G, Burell, G, Cifkova, R (2007) European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 14: pp. S1-S113 CrossRef
- Assmann, G, Benecke, H, Neiss, A, Cullen, P, Schulte, H, Bestehorn, K (2006) Gap between guidelines and practice: attainment of treatment targets in patients with primary hypercholesterolemia starting statin therapy. Results of the 4E-Registry (Efficacy Calculation and Measurement of Cardiovascular and Cerebrovascular Events Including Physicians' Experience and Evaluation). Eur J Cardiovasc Prev Rehabil 13: pp. 776-783 CrossRef
- Oldridge, N (2003) Physical activity in primary and secondary prevention - there is a treatment gap. Eur J Cardiovasc Prev Rehabil 10: pp. 317-318 CrossRef
- Turnbull, F (2005) Managing cardiovascular risk factors: the gap between evidence and practice. PLoS Med 2: pp. e131 CrossRef
- Kotseva, K, Wood, D, De Backer, G, De Bacquer, D, Pyorala, K, Reiner, Z (2010) EUROASPIRE III. Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries. Eur J Cardiovasc Prev Rehabil 17: pp. 530-540 CrossRef
- Holman, H, Lorig, K (2004) Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public Health Rep 119: pp. 239-243 CrossRef
- Lorig, KR, Holman, H (2003) Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med 26: pp. 1-7 CrossRef
- Zorgstandaard Vasculair Risicomanagement.
- Wieren, Sv, Deckers, JW, Engelfriet, PM (2010) Welke zorg gebruiken patiënten en wat zijn de kosten?. RIVM, Bilthoven
- Condon, C, McCarthy, G (2006) Lifestyle changes following acute myocardial infarction: patients perspectives. Eur J Cardiovasc Nurs 5: pp. 37-44 CrossRef
- Stolic, S, Mitchell, M, Wollin, J (2010) Nurse-led telephone interventions for people with cardiac disease: a review of the research literature. Eur J Cardiovasc Nurs 9: pp. 203-217 CrossRef
- Clark, AM, Haykowsky, M, Kryworuchko, J, MacClure, T, Scott, J, DesMeules, M (2010) A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease. Eur J Cardiovasc Prev Rehabil 17: pp. 261-270
- Neubeck, L, Redfern, J, Fernandez, R, Briffa, T, Bauman, A, Freedman, SB (2009) Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review. Eur J Cardiovasc Prev Rehabil 16: pp. 281-289 CrossRef
- Vale, MJ, Jelinek, MV, Best, JD (2002) How many patients with coronary heart disease are not achieving their risk-factor targets? Experience in Victoria 1996–1998 versus 1999–2000. Med J Aust 176: pp. 211-215
- Vale, MJ, Jelinek, MV, Best, JD, Dart, AM, Grigg, LE, Hare, DL (2003) Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med 163: pp. 2775-2783 CrossRef
- Vale, MJ (2005) Nurse-led community-based care may reduce the risk of heart disease in black people at high risk. Commentary. Evid Based Cardiovasc Med 9: pp. 211-214 CrossRef
- Campbell, NC, Ritchie, LD, Thain, J, Deans, HG, Rawles, JM, Squair, JL (1998) Secondary prevention in coronary heart disease: a randomised trial of nurse led clinics in primary care. Heart 80: pp. 447-452
- Schuit, AJ, Schouten, EG, Westerterp, KR, Saris, WH (1997) Validity of the Physical Activity Scale for the Elderly (PASE): according to energy expenditure assessed by the doubly labeled water method. J Clin Epidemiol 50: pp. 541-546 CrossRef
- Van Assema, P, Brug, J, Ronda, G, Steenhuis, I, Oenema, A (2002) A short dutch questionnaire to measure fruit and vegetable intake: relative validity among adults and adolescents. Nutr Health 16: pp. 85-106 CrossRef
- Tordoff, JM, Bagge, ML, Gray, AR, Campbell, AJ, Norris, PT (2010) Medicine-taking practices in community-dwelling people aged > or =75 years in New Zealand. Age Ageing 39: pp. 574-580 CrossRef
- Hofer, S, Lim, L, Guyatt, G, Oldridge, N (2004) The MacNew Heart Disease health-related quality of life instrument: a summary. Health Qual Life Outcomes 2: pp. 3 CrossRef
- Spinhoven, P, Ormel, J, Sloekers, PP, Kempen, GI, Speckens, AE, Van Hemert, AM (1997) A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 27: pp. 363-370 CrossRef
- Hollis, S, Campbell, F (1999) What is meant by intention to treat analysis? Survey of published randomised controlled trials. Br Med J 319: pp. 670-674 CrossRef
- Bryk, AS, Raudenbusch, SW (1992) Hierarchical linear models: Applications and data management methods. Sage Publications, Newbury park
- Blackburn, DF, Dobson, RT, Blackburn, JL, Wilson, TW, Stang, MR, Semchuk, WM (2005) Adherence to statins, beta-blockers and angiotensin-converting enzyme inhibitors following a first cardiovascular event: a retrospective cohort study. Can J Cardiol 21: pp. 485-488
- Colivicchi, F, Bassi, A, Santini, M, Caltagirone, C (2007) Discontinuation of statin therapy and clinical outcome after ischemic stroke. Stroke 38: pp. 2652-2657 CrossRef
- Jackevicius, CA, Mamdani, M, Tu, JV (2002) Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA 288: pp. 462-467 CrossRef
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2261/12/47/prepub
- The effects of Hartcoach, a life style intervention provided by telephone on the reduction of coronary risk factors: a randomised trial
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
BMC Cardiovascular Disorders
- Online Date
- June 2012
- Online ISSN
- BioMed Central
- Additional Links
- Cardiovascular disease
- Secondary prevention
- Self management
- Nurse led telephonic intervention