The effects of Hartcoach, a life style intervention provided by telephone on the reduction of coronary risk factors: a randomised trial.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.


BACKGROUND
NTR2388.
Netherlands institute for health services research, Utrecht, The Netherlands. C.Leemrijse@nivel.nl
Chantal J
CJ
Leemrijse
Liset
L
van Dijk
Harald T
HT
Jørstad
Ron J G
RJ
Peters
Cindy
C
Veenhof
D000789:Angina, Unstable / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009042:Motivation; D009203:Myocardial Infarction / Q000453:epidemiology / Q000451:nursing / Q000517:prevention & control*; D009426:Netherlands; D024802:Nurse's Role; D010353:Patient Education as Topic; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000379:methods*; D012648:Self Care; D017216:Telemedicine; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome