title: Evaluation of a telemedicine service for the secondary prevention of coronary artery disease.
abstract: OBJECTIVE
  Efficient ways are needed to implement the secondary prevention (SP) of coronary heart disease. Because few studies have investigated Web-based SP programs, our aim was to determine the usefulness of a new Web-based telemonitoring system, connecting patients provided with self-measurement devices and care managers via mobile phone text messages, as a tool for SP.
  
  
  METHODS
  A single-blind, randomized controlled, clinical trial of 203 acute coronary syndrome (ACS) survivors, was conducted at a hospital in Madrid, Spain. All patients received lifestyle counseling and usual-care treatment. Patients in the telemonitoring group (TMG) sent, through mobile phones, weight, heart rate, and blood pressure (BP) weekly, and capillary plasma lipid profile and glucose monthly. A cardiologist accessed these data through a Web interface and sent recommendations via short message service. Main outcome measures were BP, body mass index (BMI), smoking status, low-density lipoprotein-cholesterol (LDL-c), and glycated hemoglobin A₁c (HbA₁c).
  
  
  RESULTS
  At 12-month followup, TMG patients were more likely (RR = 1.4; 95% CI = 1.1-1.7) to experience improvement in cardiovascular risk factors profile than control patients (69.6% vs 50.5%, P = .010). More TMG patients achieved treatment goals for BP (62.1% vs 42.9%, P = .012) and HbA₁c (86.4% vs 54.2%, P = .018), with no differences in smoking cessation or LDL-c. Body mass index was significantly lower in TMG (-0.77 kg/m² vs +0.29 kg/m², P = .005).
  
  
  CONCLUSIONS
  A telemonitoring program, via mobile phone messages, appears to be useful for improving the risk profile in ACS survivors and can be an effective tool for secondary prevention, especially for overweight patients.
authors: Department of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain. ablasc@gmail.com
authors: Ana
authors: A
authors: Blasco
authors: Montserrat
authors: M
authors: Carmona
authors: Ignacio
authors: I
authors: Fernández-Lozano
authors: Carlos H
authors: CH
authors: Salvador
authors: Mario
authors: M
authors: Pascual
authors: Pilar G
authors: PG
authors: Sagredo
authors: Roberto
authors: R
authors: Somolinos
authors: Adolfo
authors: A
authors: Muñoz
authors: Fernando
authors: F
authors: García-López
authors: Juan M
authors: JM
authors: Escudier
authors: Susana
authors: S
authors: Mingo
authors: Jorge
authors: J
authors: Toquero
authors: Vanessa
authors: V
authors: Moñivas
authors: Miguel A
authors: MA
authors: González
authors: Juan A
authors: JA
authors: Fragua
authors: Fernando
authors: F
authors: López-Rodríguez
authors: Jose L
authors: JL
authors: Monteagudo
authors: Luis
authors: L
authors: Alonso-Pulpón
mesh_terms: D015992:Body Mass Index; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012306:Risk; D055502:Secondary Prevention / Q000379:methods*; D016037:Single-Blind Method; D016540:Smoking Cessation / Q000379:methods; D013030:Spain; D017216:Telemedicine / Q000458:organization & administration*