Effectiveness of a Nurse-Led Support Programme Using a Mobile Application versus Phone Advice on Patients at Risk of Coronary Heart Disease – A Pilot Randomized Controlled Trial

Abstract

Purpose Coronary heart disease (CHD) is the leading cause of morbidity and mortality globally. This study aimed to examine the preliminary effect of a nurse-led support programme using a mobile application versus nursing telephone advice on patients at risk of CHD living in the community. Patients and Methods A prospective randomized controlled trial was adopted. Sixty eligible CHD participants were randomized into the app group (App) or the nursing telephone advice (NTA) group to support their own health care and exercise. Data were collected at baseline (T0), 1 month (T1), and 3 months (T2). Outcomes were total amount of exercise, self-efficacy of chronic disease management, total time of exercise, blood pressure, and lipid concentrations. Data were analyzed using the generalized estimating equation models. Results Ninety-two individuals were screened for eligibility and 60 were randomized into the app group (n = 30) or NTA group (n = 30). The mean age of the participants was 60.92. The total attrition rate at T2 was 1.66%. The app group showed a moderate effect (Cohen’s d =0.43) in significant increase in exercise amount, and reduction of lipid concentration (total cholesterol d=−0.43, triglyceride d=−0.39) respectively. Other outcomes showed improvement trend but non-significant between group. Conclusion The CHD app is effective to motivate CHD patients for maintaining exercise amount which will be beneficial to their lipid control.

Effectiveness of mobile health applications on clinical outcomes and health behaviors in patients with coronary heart disease: A systematic review and meta-analysis

“…Thirty-four studies [ [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] ] were included in the systematic review, 20 in English and 14 in Chinese. The search process outcomes are shown in Fig.…”

“… Wong et al. [ 54 ] (2022) Hongkong, China Patients with at least 2 CRF, such as current smoker, ＞50 years, diabetes or hypertension, family history of IHD or hyperlipidemia, hyperlipidemia or regular medication, BMI >25, PCI and stable angina and on nitroglycerin medication 30/30 Community centers or in a university research laboratory SBP, DBP, FBS,TC, TG, LDL-C, HDL-C, weight, BMI, the incidence of MACEs, exercise time EG showed a moderate effect (Cohen’s d = 0.43) in significant increase in exercise amount, and reduction of lipid concentration (TG d = −0.43, TC d = −0.39). Yu et al.…”

“…[ 53 ] Personal health assistant (PHA) Efficacy evaluation Construct a set of guideline and evidence-based, user-friendly tasks and educational material Daily tasks and reminders; guideline-based recommendations; update the risk factors Wong et al. [ 54 ] Smartphone app Efficacy evaluation The educational area, which defines CHD and provides tips on a healthy diet, exercise, and medications E-educational contents; health and exercise records; alert/feedback messages; follow-up Yu et al. [ 55 ] Heart Health Feasibility and efficacy evaluation Many educational readings on secondary preventive cardiac care that originated from scientific guidelines Medication reminders, cardiac health education, health questionnaire and feedback; follow up Yuan et al.…”

“…[ 53 ] Mayo Clinic investigators; app Patients only received automated reminders to complete educational or recalltasks once logged into the system 3 months Personalized guidance, and the progress can be individually tracked and trended Instruct the patients on the program use in a 30-min session; contact the study team or obtain technical support, and inquiries were answered within 24 h 6 patients (16%) continued to use, 6 complaints, 7 logistical questions about the program, 5 suggestions, and 2 compliments Wong et al. [ 54 ] Trained research nurses, who were experienced in cardiac nursing; app and telephone advice Three monthly 20-min telephone follow-ups twice weekly, text messages were provided by a trained research nurse for up to 3 months 1 and 3 months Personalized health and exercise record, and alerts of risk factors The patients are encouraged to input own daily exercise time and type of exercise to arouse interest Attrition rates of 3.3% ( n = 1) and 0% at 1 month, and 3.3% ( n = 1) and 0% at 3 months in EG and CG Yu et al. [ 55 ] All researchers received uniform training before intervention; app 3 and 6 months Personalized feedback, encouragement, and advice about secondary prevention status and performance Researchers adopted a user-centered design process; help patients install and use the app 3 patients could not be contacted, and 3 died within 3 months; 5 patients could not be contacted, and 2 died within 6 months Yuan et al.…”

Relationship between self-care compliance, trust, and satisfaction among hypertensive patients in China

“…As a result, they spend limited time communicating with patients to pursue service efficiency ( 2 , 23 ), and patients are often unable to receive enough emotional support from their family doctors ( 24 ). Due to the impossibility to increase the number of healthcare professionals in a short time, it might be possible to improve the current situation of physician-patient trust by using text messaging and mobile app ( 51 , 52 ), which provided a new way to bridge the relationship between physicians and patients. Additionally, this study also shows that female patients exhibit higher trust scores than male patients, in line with a previous study ( 53 ).…”