Patient education interventions for health behaviour change in adults diagnosed with coronary heart disease: a systematic review and meta-analysis

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
W Shi ◽  
GLM Ghisi ◽  
L Zhang ◽  
K Hyun ◽  
M Pakosh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Patient Education ◽  
Health Behaviour ◽  
Meta Analysis ◽  
Dietary Behaviour ◽  
Flow Diagram ◽  
Phone Calls ◽  
Chd Risk Factors

Abstract Funding Acknowledgements Type of funding sources: None. Background Patient education is recommended to increase disease-related knowledge and modify coronary heart disease (CHD) risk factors. Although the importance has been established, there is a lack of knowledge of its efficacy and relative impact of duration on disease-related knowledge and health behaviour outcomes. Purpose It aimed to assess the efficacy of structured patient education on those outcomes in adults with CHD for short-term (less than six months) and long-term (six to 12 months) effect. Methods Eligible randomised controlled trials published in English, Simplified Chinese, Spanish, and Portuguese were searched in seven electronic databases from database inception through 2020. Reference lists, relevant conference lists, and keywords from the Internet were also searched. Outcomes included disease-related knowledge, smoking cessation, medication adherence, physical activity, and healthy dietary behaviour. Results Overall, 73 studies reporting 71 unique trials were included. Participants (n = 24,985) were aged mean 60.5 ± 5.7 years, mostly male (72.5%). About 74% of studies used more than one mode for education delivery, with phone calls and booklets being used the most frequent. Patient education was associated with significant improvement in all outcomes measured in meta-analyses (P < 0.05). In addition, regression analyses showed that a prolonged intervention duration does not significantly improve the outcomes, except for the disease knowledge (p = 0.009) and physical activity (p = 0.026). Conclusions Structured patient education, in a variety of modes and intensities, improves disease-related knowledge and health behaviours in adults with CHD. The findings can be used to guide design of cardiac programs, particularly related to intervention duration in clinical practice. Abstract Figure 1. PRISMA flow diagram

scholarly journals The impact of clinical and population strategies on coronary heart disease mortality: an assessment of Rose’s big idea

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohadeseh Ahmadi ◽  
Bruce Lanphear
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Coronary Heart Disease Mortality ◽  
Cross Sectional ◽  
Population Strategy ◽  
Chd Risk Factors ◽  
The Impact ◽  
Clinical Strategy

Abstract Background Coronary heart disease (CHD), the leading cause of death worldwide, has declined in many affluent countries but it continues to rise in industrializing countries. Objective To quantify the relative contribution of the clinical and population strategies to the decline in CHD mortality in affluent countries. Design Meta-analysis of cross-sectional and prospective studies. Data sources PubMed and Web of Science from January 1, 1970 to December 31, 2019. Method We combined and analyzed data from 22 cross-sectional and prospective studies, representing 500 million people, to quantify the relative decline in CHD mortality attributable to the clinical strategy and population strategy. Result The population strategy accounted for 48% (range = 19 to 73%) of the decline in CHD deaths and the clinical strategy accounted for 42% (range = 25 to 56%), with moderate inconsistency of results across studies. Conclusion Since 1970, a larger fraction of the decline in CHD deaths in industrialized countries was attributable to reduction in CHD risk factors than medical care. Population strategies, which are more cost-effective than clinical strategies, are under-utilized.

Evaluation of an Integrated Telemonitoring Surveillance System in Patients with Coronary Heart Disease

2015 ◽  
Vol 54 (05) ◽  
pp. 388-397 ◽  
Author(s):  
S. Woess ◽  
C. Baumgartner ◽  
B. Fetz ◽  
A. van der Heidt ◽  
P. Kastner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Health Status ◽  
Patient Education ◽  
Lifestyle Changes ◽  
Study Entry ◽  
Adherence To Medication

SummaryObjectives: Cardiovascular diseases are the most frequent cause of death in industrialized countries. Non-adherence with prescribed medication and recommended lifestyle changes significantly increases the risk of major cardiovascular events. The telemonitoring programme MyCor (Myokardinfarkt und Koronarstent Programm in Tirol) is a multi-modal intervention programme to improve lifestyle and medication management of patients with coronary heart disease (CHD). It includes patient education, self-monitoring with goal-setting and feedback, and regular clinical visits. We evaluated the MyCor telemonitoring programme regarding technical feasibility, user acceptance, patient adherence, change in health status, and change in quality of life.Methods: A 4½-month study was conducted with two telemonitoring phases and one interim phase. The study comprised patient surveys, standardized assessment of quality of life using the MacNew questionnaire at study entry and after 4 and 18 weeks, analysis of adherence to medication and physical activity during the two telemonitoring phases, and analysis of reached goals regarding health conditions during the telemonitoring phases.Results: Twenty-five patients (mean age: 63 years) participated in the study. Patients showed a high acceptance of the MyCor tele-monitoring programme. Patients reported feelings of self-control, motivation for lifestyle changes, and improved quality of life. Adherence to daily measurements was high with 86% and 77% in the two telemonitoring phases. Adherence to medication was also high with up to 87% and 80%. Pre-defined goals for physical activity were reached in up to 86% and 73% of days, respectively. Quality of life improved from 5.5 at study entry to 6.3 at the end (p< 0.01; MacNew questionnaire). Reductions in blood pressure and heart rate or an improvement in reaching defined goals could not be observed.Conclusions: The MyCor telemonitoring programme Tirol for CHD patients has a high rate of acceptance among included patients. Critical evaluation revealed subjective benefits regarding quality of life and health status as well as high adherence rates to medication and lifestyle changes. Achieving long-term adherence and verifying clinical outcomes, however, remains an open issue. Our findings will promote further studies, addressing different strategies for an optimal mix of patient education, telemonitoring, feedback, and clinical follow-ups.

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