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Published in: BMC Cardiovascular Disorders 1/2012

Open Access 01-12-2012 | Study protocol

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

Authors: Chantal J Leemrijse, Liset van Dijk, Harald T Jørstad, Ron J G Peters, Cindy Veenhof

Published in: BMC Cardiovascular Disorders | Issue 1/2012

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Abstract

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/design

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.

Discussion

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.

Trial registration

NTR2388
Literature
1.
2.
go back to reference Patel AV, Bernstein L, Deka A, Feigelson HS, Campbell PT, Gapstur SM, et al: Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol. 2010, 172: 419-429. 10.1093/aje/kwq155.CrossRefPubMedPubMedCentral Patel AV, Bernstein L, Deka A, Feigelson HS, Campbell PT, Gapstur SM, et al: Leisure time spent sitting in relation to total mortality in a prospective cohort of US adults. Am J Epidemiol. 2010, 172: 419-429. 10.1093/aje/kwq155.CrossRefPubMedPubMedCentral
3.
go back to reference Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al: 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. 2007, 14 (Suppl 2): S1-S113.CrossRefPubMed Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al: 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. 2007, 14 (Suppl 2): S1-S113.CrossRefPubMed
4.
go back to reference Assmann G, Benecke H, Neiss A, Cullen P, Schulte H, Bestehorn K: 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. 2006, 13: 776-783. 10.1097/01.hjr.0000189805.76482.6e.CrossRefPubMed Assmann G, Benecke H, Neiss A, Cullen P, Schulte H, Bestehorn K: 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. 2006, 13: 776-783. 10.1097/01.hjr.0000189805.76482.6e.CrossRefPubMed
5.
go back to reference Oldridge N: Physical activity in primary and secondary prevention - there is a treatment gap. Eur J Cardiovasc Prev Rehabil. 2003, 10: 317-318. 10.1097/01.hjr.0000099030.73419.67.CrossRefPubMed Oldridge N: Physical activity in primary and secondary prevention - there is a treatment gap. Eur J Cardiovasc Prev Rehabil. 2003, 10: 317-318. 10.1097/01.hjr.0000099030.73419.67.CrossRefPubMed
6.
7.
go back to reference Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Reiner Z, et al: 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. 2010, 17: 530-540. 10.1097/HJR.0b013e3283383f30.CrossRefPubMed Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Reiner Z, et al: 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. 2010, 17: 530-540. 10.1097/HJR.0b013e3283383f30.CrossRefPubMed
8.
go back to reference Holman H, Lorig K: Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public Health Rep. 2004, 119: 239-243. 10.1016/j.phr.2004.04.002.CrossRefPubMedPubMedCentral Holman H, Lorig K: Patient self-management: a key to effectiveness and efficiency in care of chronic disease. Public Health Rep. 2004, 119: 239-243. 10.1016/j.phr.2004.04.002.CrossRefPubMedPubMedCentral
9.
go back to reference Lorig KR, Holman H: Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003, 26: 1-7. 10.1207/S15324796ABM2601_01.CrossRefPubMed Lorig KR, Holman H: Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003, 26: 1-7. 10.1207/S15324796ABM2601_01.CrossRefPubMed
10.
go back to reference Platform Vitale Vaten: Zorgstandaard Vasculair Risicomanagement. 2009 Platform Vitale Vaten: Zorgstandaard Vasculair Risicomanagement. 2009
11.
go back to reference Wieren Sv, Deckers JW, Engelfriet PM: Welke zorg gebruiken patiënten en wat zijn de kosten?. 2010, Bilthoven: RIVM Wieren Sv, Deckers JW, Engelfriet PM: Welke zorg gebruiken patiënten en wat zijn de kosten?. 2010, Bilthoven: RIVM
12.
go back to reference Condon C, McCarthy G: Lifestyle changes following acute myocardial infarction: patients perspectives. Eur J Cardiovasc Nurs. 2006, 5: 37-44. 10.1016/j.ejcnurse.2005.06.005.CrossRefPubMed Condon C, McCarthy G: Lifestyle changes following acute myocardial infarction: patients perspectives. Eur J Cardiovasc Nurs. 2006, 5: 37-44. 10.1016/j.ejcnurse.2005.06.005.CrossRefPubMed
13.
go back to reference Stolic S, Mitchell M, Wollin J: Nurse-led telephone interventions for people with cardiac disease: a review of the research literature. Eur J Cardiovasc Nurs. 2010, 9: 203-217. 10.1016/j.ejcnurse.2010.02.003.CrossRefPubMed Stolic S, Mitchell M, Wollin J: Nurse-led telephone interventions for people with cardiac disease: a review of the research literature. Eur J Cardiovasc Nurs. 2010, 9: 203-217. 10.1016/j.ejcnurse.2010.02.003.CrossRefPubMed
14.
go back to reference Clark AM, Haykowsky M, Kryworuchko J, MacClure T, Scott J, DesMeules M, et al: A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease. Eur J Cardiovasc Prev Rehabil. 2010, 17: 261-270.PubMed Clark AM, Haykowsky M, Kryworuchko J, MacClure T, Scott J, DesMeules M, et al: A meta-analysis of randomized control trials of home-based secondary prevention programs for coronary artery disease. Eur J Cardiovasc Prev Rehabil. 2010, 17: 261-270.PubMed
15.
go back to reference Neubeck L, Redfern J, Fernandez R, Briffa T, Bauman A, Freedman SB: Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review. Eur J Cardiovasc Prev Rehabil. 2009, 16: 281-289. 10.1097/HJR.0b013e32832a4e7a.CrossRefPubMed Neubeck L, Redfern J, Fernandez R, Briffa T, Bauman A, Freedman SB: Telehealth interventions for the secondary prevention of coronary heart disease: a systematic review. Eur J Cardiovasc Prev Rehabil. 2009, 16: 281-289. 10.1097/HJR.0b013e32832a4e7a.CrossRefPubMed
16.
go back to reference Vale MJ, Jelinek MV, Best JD: 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. 2002, 176: 211-215.PubMed Vale MJ, Jelinek MV, Best JD: 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. 2002, 176: 211-215.PubMed
17.
go back to reference Vale MJ, Jelinek MV, Best JD, Dart AM, Grigg LE, Hare DL, et al: Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med. 2003, 163: 2775-2783. 10.1001/archinte.163.22.2775.CrossRefPubMed Vale MJ, Jelinek MV, Best JD, Dart AM, Grigg LE, Hare DL, et al: Coaching patients On Achieving Cardiovascular Health (COACH): a multicenter randomized trial in patients with coronary heart disease. Arch Intern Med. 2003, 163: 2775-2783. 10.1001/archinte.163.22.2775.CrossRefPubMed
18.
go back to reference Vale MJ: Nurse-led community-based care may reduce the risk of heart disease in black people at high risk. Commentary. Evid Based Cardiovasc Med. 2005, 9: 211-214.CrossRefPubMed Vale MJ: Nurse-led community-based care may reduce the risk of heart disease in black people at high risk. Commentary. Evid Based Cardiovasc Med. 2005, 9: 211-214.CrossRefPubMed
19.
go back to reference Campbell NC, Ritchie LD, Thain J, Deans HG, Rawles JM, Squair JL: Secondary prevention in coronary heart disease: a randomised trial of nurse led clinics in primary care. Heart. 1998, 80: 447-452.CrossRefPubMedPubMedCentral Campbell NC, Ritchie LD, Thain J, Deans HG, Rawles JM, Squair JL: Secondary prevention in coronary heart disease: a randomised trial of nurse led clinics in primary care. Heart. 1998, 80: 447-452.CrossRefPubMedPubMedCentral
20.
go back to reference Schuit AJ, Schouten EG, Westerterp KR, Saris WH: Validity of the Physical Activity Scale for the Elderly (PASE): according to energy expenditure assessed by the doubly labeled water method. J Clin Epidemiol. 1997, 50: 541-546. 10.1016/S0895-4356(97)00010-3.CrossRefPubMed Schuit AJ, Schouten EG, Westerterp KR, Saris WH: Validity of the Physical Activity Scale for the Elderly (PASE): according to energy expenditure assessed by the doubly labeled water method. J Clin Epidemiol. 1997, 50: 541-546. 10.1016/S0895-4356(97)00010-3.CrossRefPubMed
21.
go back to reference Van Assema P, Brug J, Ronda G, Steenhuis I, Oenema A: A short dutch questionnaire to measure fruit and vegetable intake: relative validity among adults and adolescents. Nutr Health. 2002, 16: 85-106. 10.1177/026010600201600203.CrossRefPubMed Van Assema P, Brug J, Ronda G, Steenhuis I, Oenema A: A short dutch questionnaire to measure fruit and vegetable intake: relative validity among adults and adolescents. Nutr Health. 2002, 16: 85-106. 10.1177/026010600201600203.CrossRefPubMed
22.
go back to reference Tordoff JM, Bagge ML, Gray AR, Campbell AJ, Norris PT: Medicine-taking practices in community-dwelling people aged > or =75 years in New Zealand. Age Ageing. 2010, 39: 574-580. 10.1093/ageing/afq069.CrossRefPubMed Tordoff JM, Bagge ML, Gray AR, Campbell AJ, Norris PT: Medicine-taking practices in community-dwelling people aged > or =75 years in New Zealand. Age Ageing. 2010, 39: 574-580. 10.1093/ageing/afq069.CrossRefPubMed
23.
go back to reference Hofer S, Lim L, Guyatt G, Oldridge N: The MacNew Heart Disease health-related quality of life instrument: a summary. Health Qual Life Outcomes. 2004, 2: 3-10.1186/1477-7525-2-3.CrossRefPubMedPubMedCentral Hofer S, Lim L, Guyatt G, Oldridge N: The MacNew Heart Disease health-related quality of life instrument: a summary. Health Qual Life Outcomes. 2004, 2: 3-10.1186/1477-7525-2-3.CrossRefPubMedPubMedCentral
24.
go back to reference Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM: A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997, 27: 363-370. 10.1017/S0033291796004382.CrossRefPubMed Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM: A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997, 27: 363-370. 10.1017/S0033291796004382.CrossRefPubMed
25.
go back to reference Hollis S, Campbell F: What is meant by intention to treat analysis? Survey of published randomised controlled trials. Br Med J. 1999, 319: 670-674. 10.1136/bmj.319.7211.670.CrossRef Hollis S, Campbell F: What is meant by intention to treat analysis? Survey of published randomised controlled trials. Br Med J. 1999, 319: 670-674. 10.1136/bmj.319.7211.670.CrossRef
26.
go back to reference Bryk AS, Raudenbusch SW: Hierarchical linear models: Applications and data management methods. 1992, Newbury park: Sage Publications Bryk AS, Raudenbusch SW: Hierarchical linear models: Applications and data management methods. 1992, Newbury park: Sage Publications
27.
go back to reference Blackburn DF, Dobson RT, Blackburn JL, Wilson TW, Stang MR, Semchuk WM: Adherence to statins, beta-blockers and angiotensin-converting enzyme inhibitors following a first cardiovascular event: a retrospective cohort study. Can J Cardiol. 2005, 21: 485-488.PubMed Blackburn DF, Dobson RT, Blackburn JL, Wilson TW, Stang MR, Semchuk WM: Adherence to statins, beta-blockers and angiotensin-converting enzyme inhibitors following a first cardiovascular event: a retrospective cohort study. Can J Cardiol. 2005, 21: 485-488.PubMed
28.
go back to reference Colivicchi F, Bassi A, Santini M, Caltagirone C: Discontinuation of statin therapy and clinical outcome after ischemic stroke. Stroke. 2007, 38: 2652-2657. 10.1161/STROKEAHA.107.487017.CrossRefPubMed Colivicchi F, Bassi A, Santini M, Caltagirone C: Discontinuation of statin therapy and clinical outcome after ischemic stroke. Stroke. 2007, 38: 2652-2657. 10.1161/STROKEAHA.107.487017.CrossRefPubMed
29.
go back to reference Jackevicius CA, Mamdani M, Tu JV: Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002, 288: 462-467. 10.1001/jama.288.4.462.CrossRefPubMed Jackevicius CA, Mamdani M, Tu JV: Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002, 288: 462-467. 10.1001/jama.288.4.462.CrossRefPubMed
Metadata
Title
The effects of Hartcoach, a life style intervention provided by telephone on the reduction of coronary risk factors: a randomised trial
Authors
Chantal J Leemrijse
Liset van Dijk
Harald T Jørstad
Ron J G Peters
Cindy Veenhof
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2012
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-12-47

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