Encouraging Self-Management in Cardiovascular Disease Prevention

Tinsel, Iris; Siegel, Achim; Schmoor, Claudia; Poguntke, Inga; Maun, Andy; Niebling, Wilhelm

doi:10.3238/arztebl.2018.0469

Cited by 4 publications

(31 citation statements)

References 23 publications

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“…In turn, coronary heart disease self-management is present in 18% [ 52 , 53 , 54 , 55 , 56 , 57 , 58 ]. Additionally, 16% of the papers explore the self-management of several CVDs simultaneously [ 59 , 60 , 61 , 62 , 63 , 64 ].…”

Section: Discussionmentioning

confidence: 99%

“…mHealth apps such as those reported in [ 59 , 60 , 61 , 62 , 63 , 64 ] aim at supporting the self-management of multiple CVDs. These mHealth apps mainly provide medical follow-up recommendations for physical activity or dietary plans.…”

Section: Discussionmentioning

confidence: 99%

“…To summarize our findings on the main functionalities of mHealth apps for CVD self-management, 57.9% of these apps issue medical recommendations to patients [ 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 39 , 40 , 45 , 52 , 53 , 54 , 58 , 60 , 61 , 62 , 63 ], whereas 47.3% can generate reminding notifications or alerts for medical appointments [ 27 , 29 , 34 , 35 , 36 , 37 , 40 , 45 , 51 , 52 , 54 , 55 , 57 , 58 , 59 , 60 , 62 , 64 ]. Additionally, 34.2% of these apps monitor patient parameters, such as physical activity, step count, weight control, blood pressure, heart rate, pulse wave, and body temperature [ 27 , 28 , 29 , 38 , 44 , 48 , 51 , 56 ,…”

Section: Discussionmentioning

confidence: 99%

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mHealth Apps for Self-Management of Cardiovascular Diseases: A Scoping Review

et al. 2022

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The use of mHealth apps for the self-management of cardiovascular diseases (CVDs) is an increasing trend in patient-centered care. In this research, we conduct a scoping review of mHealth apps for CVD self-management within the period 2014 to 2021. Our review revolves around six main aspects of the current status of mHealth apps for CVD self-management: main CVDs managed, main app functionalities, disease stages managed, common approaches used for data extraction, analysis, management, common wearables used for CVD detection, monitoring and/or identification, and major challenges to overcome and future work remarks. Our review is based on Arksey and O’Malley’s methodological framework for conducting studies. Similarly, we adopted the PRISMA model for reporting systematic reviews and meta-analyses. Of the 442 works initially retrieved, the review comprised 38 primary studies. According to our results, the most common CVDs include arrhythmia (34%), heart failure (32%), and coronary heart disease (18%). Additionally, we found that the majority mHealth apps for CVD self-management can provide medical recommendations, medical appointments, reminders, and notifications for CVD monitoring. Main challenges in the use of mHealth apps for CVD self-management include overcoming patient reluctance to use the technology and achieving the interoperability of mHealth applications with other systems.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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mHealth Apps for Self-Management of Cardiovascular Diseases: A Scoping Review

et al. 2022

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“…DECADE was successfully tested in the two-arm randomised DECADE pilot study with 6 GPs and 78 patients in South Baden (Germany). 41 All the patients received a calculation of their individual 10-year risk of CVD using the ‘arriba’ calculator along with 3–4 follow-up consultations within 4 months. In one of two intervention arms, printed DECADE brochures were additionally offered to the patients.…”

Section: Introductionmentioning

confidence: 99%

Encouragement of patients’ self-management in primary care for the prevention of cardiovascular diseases (DECADE): protocol for a cluster randomised controlled trial

et al. 2023

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IntroductionCardiovascular diseases are the most common cause of death in Germany and among the most frequent reasons for encounters in primary care. Most patients with cardiovascular risks (CVRs) have difficulties implementing health-promoting behavioural changes. In this study, a complex intervention containing evidence-based patient materials and structured follow-up consultations are intended to strengthen patients’ self-management to improve health behaviour.Methods and analysisIn this cluster randomised controlled trial, we investigate the effects of the intervention "Decision aid, action planning and follow-up support for patients to reduce the 10-year risk of cardiovascular diseases" (DECADE) using a 2×2 design. All patients, including the control group (CG), receive a CVR calculation. Three intervention groups (IGs) receive one or both of two different components of the DECADE intervention: IG1 (patient materials), IG2 (follow-up consultations) and IG3 (patient materials and follow-up consultations). The study was planned to be conducted with 77 general practitioners in 3 German regions and a target sample size of 924 patients. The observation period for each patient amounts to 12 months with three patient surveys: baseline (t0), after 6 and 12 months (t1 and t2). The primary outcome is patient activation (Patient Activation Measure 13 (PAM13-D)) at t1. Secondary outcomes include PAM13-D at t2 and further patient-reported and clinical outcomes at t1 and t2. We will also analyse the cost-effectiveness of the intervention, the degree of usage and satisfaction with the intervention.Ethics and disseminationThe study was first approved by the lead ethics committee of the University of Freiburg on 15 April 2021 (vote number: 21-1078) and subsequently by the other ethics committees in the study regions (Ethics committee of medical association Baden-Württemberg (B-F-2021-078), Ethics Committee of the Technische Universität Dresden, Dresden (BO-EK-251052021), Ethics Committee of the State Chamber of Physicians of Saxony (EK-BR-92/21-1), Ethics Committee of the Hamburg Medical Association (2021-200013-BO-bet)). Informed consent is required for patients to participate in the study. The results of this study will be published in peer-reviewed journals and presented at congresses by the DECADE team. The DECADE lead management will communicate the results to the funder of this study.Trial registration numberGerman Clinical Trials Register, DRKS00025401 (registration date: 21 June 2021); International Clinical Trials Registry Platform, DRKS00025401.

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“…Findings from individual studies suggest that PAct interventions can significantly decrease weight and blood pressure and improve glycaemic control in people with overweight or obesity 33 as well as reducing risk factors for CVD, such as smoking and lack of exercise. 34 However, to our knowledge, no systematic review has assessed the effects of PAct interventions for adults with overweight, obesity or CVD.…”

Section: Introductionmentioning

confidence: 99%

Association between patient activation, self-management behaviours and clinical outcomes in adults with diabetes or related metabolic disorders: a systematic review and meta-analysis protocol

et al. 2022

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IntroductionDiabetes and related metabolic disorders such as obesity and cardiovascular diseases (CVD) are a growing global issue. Equipping individuals with the necessary ‘knowledge, skills and confidence to self-manage their health’ (ie, patient activation (PAct)) may lead to improvements in health outcomes. It is unclear whether existing evidence allows us to assume a causal relationship. We aim to synthesise and critically appraise evidence on the relationship between PAct and self-management behaviours and clinical outcomes of people living with diabetes and related metabolic disorders.Methods and analysisThe protocol is based on guidance on Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. We will search Medline, Embase, CENTRAL, PsycInfo, Web of Science and CINAHL using search terms related to PAct, diabetes, pre-diabetes, obesity and CVD. Any quantitative study design is eligible provided studies assess the association between PAct and clinical outcomes and/or self-management behaviours of diabetes and related metabolic disorders. Outcomes include behavioural (eg, diet) and clinical (eg, blood pressure) outcomes. Two reviewers will independently screen titles/abstracts and full texts and assess risk of bias using the revised Cochrane risk-of-bias tool for randomised trials or the Risk of Bias Assessment Tool for Nonrandomised Studies (RoBANS).One reviewer will extract data, with independent checking by a second reviewer. We will critically assess the level of evidence available for assuming a causal association between PAct and outcomes. Data permitting, we will use the Hunter-Schmidt random-effects method to meta-analyse correlations across studies.Ethics and disseminationEthical approval is not required. The review will be disseminated in the form of a peer-reviewed journal article, at conferences and other presentations. The findings of the review will be of interest to clinical commissioning groups, policymakers and intervention deliverers/developers.PROSPERO registration numberCRD42021230727.

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Encouraging Self-Management in Cardiovascular Disease Prevention

Abstract: This pilot study shows that DECADE can support patient activation. The effects can be expected to be stronger in a larger study and in comparison to usual care. If this can be confirmed, DECADE should be embedded in routine patient care.

Cited by 4 publications

References 23 publications

mHealth Apps for Self-Management of Cardiovascular Diseases: A Scoping Review

mHealth Apps for Self-Management of Cardiovascular Diseases: A Scoping Review

Encouragement of patients’ self-management in primary care for the prevention of cardiovascular diseases (DECADE): protocol for a cluster randomised controlled trial

Association between patient activation, self-management behaviours and clinical outcomes in adults with diabetes or related metabolic disorders: a systematic review and meta-analysis protocol

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