Efficacy of an Electronic Health Management Program for Patients With Cardiovascular Risk: Randomized Controlled Trial

Young Ho Yun, EunKyo Kang, Young Min Cho, Sang Min Park, Yong-Jin Kim, Hae-Young Lee, Kyae Hyung Kim, Kiheon Lee, Hye Yeon Koo, Soojeong Kim, YeEun Rhee, Jihye Lee, Jeong Hee Min, Jin-Ah Sim, Young Ho Yun, EunKyo Kang, Young Min Cho, Sang Min Park, Yong-Jin Kim, Hae-Young Lee, Kyae Hyung Kim, Kiheon Lee, Hye Yeon Koo, Soojeong Kim, YeEun Rhee, Jihye Lee, Jeong Hee Min, Jin-Ah Sim

Abstract

Background: In addition to medication, health behavior management is crucial in patients with multiple risks of cardiovascular mortality.

Objective: This study aimed to examine the efficacy of a 3-month Smart Management Strategy for Health-based electronic program (Smart Healthing).

Methods: A 2-arm randomized controlled trial was conducted to assess the efficacy of Smart Healthing in 106 patients with at least one indicator of poor disease control and who had hypertension, diabetes, or hypercholesterolemia. The intervention group (n=53) took part in the electronic program, which was available in the form of a mobile app and a Web-based PC application. The program covered 4 areas: self-assessment, self-planning, self-learning, and self-monitoring by automatic feedback. The control group (n=53) received basic educational material concerning disease control. The primary outcome was the percentage of participants who achieved their clinical indicator goal after 12 weeks into the program: glycated hemoglobin (HbA1c) <7.0%, systolic blood pressure (SBP) <140 mmHg, or low-density lipoprotein cholesterol <130 mg/dL.

Results: The intervention group showed a significantly higher success rate (in comparison with the control group) for achieving each of 3 clinical indicators at the targeted goal levels (P<.05). Only the patients with hypertension showed a significant improvement in SBP from the baseline as compared with the control group (72.7% vs 35.7%; P<.05). There was a significant reduction in HbA1c in the intervention group compared with the control group (difference=0.54%; P≤.05). In the intervention group, 20% of patients with diabetes exhibited a ≥1% decrease in HbA1c (vs 0% among controls; P≤.05).

Conclusions: A short-term self-management strategy-based electronic program intervention may improve clinical outcomes among patients with cardiovascular risks.

Trial registration: ClinicalTrials.gov NCT03294044; https://ichgcp.net/clinical-trials-registry/NCT03294044.

Keywords: diabetes; health; hypercholesterolemia; hypertension; randomized controlled trial.

Conflict of interest statement

Conflicts of Interest: None declared.

©Young Ho Yun, EunKyo Kang, Young Min Cho, Sang Min Park, Yong-Jin Kim, Hae-Young Lee, Kyae Hyung Kim, Kiheon Lee, Hye Yeon Koo, Soojeong Kim, YeEun Rhee, Jihye Lee, Jeong Hee Min, Jin-Ah Sim. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 22.01.2020.

Figures

Figure 1
Figure 1
Flowchart depicting the study methodology

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