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NMR Metabolomics-Based Risk Assessment and Stratified Digital Health Interventions in Middle-Aged Adults (PREMAP) (PREMAP)

10 września 2026 zaktualizowane przez: Janne Martikainen, University of Eastern Finland

Effectiveness and Cost-Effectiveness of NMR Metabolomics-Based Risk Assessment and Stratified Preventive Digital and Guideline-Directed Interventions in a Middle-Aged Population: A Population Cohort Study With an Embedded Pragmatic Randomised Trial and Health Economic Evaluation

PREMAP invites residents of the Eloisa region (South Savo, Finland) turning 45, 50, or 55 years of age in 2026 to undergo a blood-based NMR metabolomics risk assessment for five interlinked cardio-renal-metabolic conditions (type 2 diabetes, coronary heart disease/myocardial infarction, stroke/cardiovascular disease, chronic kidney disease, and fatty liver disease), alongside a mental wellbeing assessment (WHO-5 Well-Being Index). Based on this risk profile, participants are classified as low, moderate, or high multi-disease risk. Participants at moderate or high risk are individually randomized in a 1:1:1 ratio to one of three digital health interventions for up to 12 months: a habit-based lifestyle application (BitHabit), a structured digital lifestyle coaching programme (Onnikka), or a guideline-based digital self-care pathway (Oma Eloisa, comparator). Participants at high risk additionally receive a physician consultation and optimization of guideline-directed medical therapy. All participants, including the non-randomized low-risk group, are followed prospectively at baseline, 6 months, and 12 months. The study evaluates whether early risk identification and risk-stratified digital interventions reduce future disease risk and improve wellbeing and estimates the cost-effectiveness of the overall approach for the Finnish healthcare system.

Przegląd badań

Status

Jeszcze nie rekrutacja

Warunki

Interwencja / Leczenie

Szczegółowy opis

The study addresses an evidence gap: no published pragmatic, randomized trial has directly compared digital lifestyle intervention platforms in a population prospectively risk-stratified through NMR metabolomics in a real-world public-sector setting. PREMAP combines a prospective, population-based cohort (all enrolled participants, followed regardless of risk group) with an embedded pragmatic, open-label, three-arm randomized controlled trial restricted to participants classified as moderate or high multi-disease risk. The non-randomized low-risk group receives its risk result and general health information and is followed as a naturalistic reference group; withholding a risk result or randomizing this group to an active digital intervention was judged neither scientifically nor ethically justified.

At the population cohort level, the study evaluates change from baseline to 6 months in the five NMR-derived disease-specific risk predictions and in the WHO-5 wellbeing score across all enrolled participants. Within the embedded randomised substudy, the three digital health arms are compared head-to-head on the same two outcome domains at 6 months, adjusting for guideline-directed medical therapy status and relevant covariates. Secondary objectives include patient-reported outcomes (health-related quality of life, work productivity, health activation, life satisfaction), clinical and health-register-based outcomes (incident diagnoses, new prescriptions, hospitalization, sickness absence) over at least 12 months, and a health economic evaluation using patient-level Monte Carlo microsimulation to estimate cost per quality-adjusted life year (QALY) gained, from both healthcare payer and societal perspectives.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

1400

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły

Akceptuje zdrowych ochotników

Tak

Opis

Inclusion Criteria:

  • Permanent resident of the Eloisa Wellbeing Services County (South Savo, Finland), or has selected Eloisa primary health care as their primary public care provider
  • Turning 45, 50, or 55 years of age during calendar year 2026
  • NMR metabolomics-based risk assessment result classified as low, moderate, or high multi-disease risk
  • Able to provide written informed consent digitally
  • Able to use a smartphone, tablet, or computer for digital application access
  • Resident of Finland with a Finnish personal identity code (required for health register linkage)

Exclusion Criteria:

  • Currently pregnant or breastfeeding
  • Incarcerated or under forensic psychiatric care
  • Significantly impaired capacity for self-determination
  • Insufficient proficiency in Finnish to provide informed consent and complete study procedures
  • No Finnish personal identity code

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Zapobieganie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Pojedynczy

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Arm 1: BitHabit
Digital, self-directed lifestyle behavior-change smartphone application based on habit-formation and behavioral-economics principles. Provides personalized, small, achievable habit suggestions targeting physical activity, nutrition, sleep, stress management and recovery. Active engagement up to 6 months from randomization; app access continues to 12 months.
Arm 1: BitHabit digital lifestyle app (12 months); Arm 2: Onnikka digital lifestyle coaching (12 months); Arm 3: Oma Eloisa digital self-care pathway (comparator). High-risk participants additionally receive physician consultation + Guideline-Directed Medical Treatment (GDMT) optimisation in the high-risk arm.
Inne nazwy:
  • BitHabit digital lifestyle app
  • Onnikka digital lifestyle coachingy
  • Oma Eloisa digital self-care pathway
Eksperymentalny: Arm 2: Onnikka
Digital lifestyle coaching programme grounded in cognitive behavioral therapy and acceptance and commitment therapy, focused on sustainable weight management and metabolic risk reduction through structured programme modules, automated check-ins and optional peer support. Active engagement up to 12 months from randomization.
Arm 1: BitHabit digital lifestyle app (12 months); Arm 2: Onnikka digital lifestyle coaching (12 months); Arm 3: Oma Eloisa digital self-care pathway (comparator). High-risk participants additionally receive physician consultation + Guideline-Directed Medical Treatment (GDMT) optimisation in the high-risk arm.
Inne nazwy:
  • BitHabit digital lifestyle app
  • Onnikka digital lifestyle coachingy
  • Oma Eloisa digital self-care pathway
Aktywny komparator: Arm 3: Oma Eloisa
Structured digital self-care pathway based on national clinical guidelines, providing lifestyle information, guidance and self-monitoring tools without personalized coaching or professional support. Represents the current standard of digital support available in the Eloisa region and is used as the comparator arm; low-risk participants also use this pathway on a non-randomized basis. Continuous access throughout the follow-up period (up to 12 months).
Arm 1: BitHabit digital lifestyle app (12 months); Arm 2: Onnikka digital lifestyle coaching (12 months); Arm 3: Oma Eloisa digital self-care pathway (comparator). High-risk participants additionally receive physician consultation + Guideline-Directed Medical Treatment (GDMT) optimisation in the high-risk arm.
Inne nazwy:
  • BitHabit digital lifestyle app
  • Onnikka digital lifestyle coachingy
  • Oma Eloisa digital self-care pathway

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
NMR-derived disease-specific 10-year risk predictions
Ramy czasowe: Baseline to 6 months
Change from baseline in NMR-derived disease-specific 10-year risk predictions (type 2 diabetes, coronary heart disease/myocardial infarction, stroke/cardiovascular disease, chronic kidney disease, fatty liver disease)
Baseline to 6 months
The World Health Organization-Five Well-Being Index (WHO-5)
Ramy czasowe: Baseline to 6 months (primary); baseline to 12 months (secondary time point)
Change from baseline in WHO-5 Well-Being Index. A percentage score ranging from zero to 100; zero represents worst possible mental well-being; a score of 100 represents best possible mental well-being.
Baseline to 6 months (primary); baseline to 12 months (secondary time point)

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
EuroQoL 5-Dimension 5-Level (EQ-5D-5L)
Ramy czasowe: baseline and at 6 and 12 months
EQ-5D-5L index score (obtained applying the Nordic value sets (Denmark, Norway, Sweden)) ranging from -0.285 to one; -0.285 indicates condition worse than death and one full health.
baseline and at 6 and 12 months
Incident diagnoses of the five target conditions
Ramy czasowe: Over at least 12 months
Unit of measurement is incidence of Chronic Kidney Disease, Type 2 Diabetes, Myocardial Infarction, Stroke, and Fatty Liver Disease (MASLD). Measurement tool from health registers (Eloisa´s EHR system, AvoHilmo, Hilmo).
Over at least 12 months
Cost-effectiveness
Ramy czasowe: Over at least 12 months
Incremental cost per quality-adjusted life year (QALY) gained across the three intervention arms and at the population level, estimated via microsimulation, from healthcare payer and societal perspectives
Over at least 12 months
Work Productivity and Activity Impairment - General Health (WPAI-GH)
Ramy czasowe: Baseline to 6 and 12 months
Four WPAI-GH subscales: absenteeism, presenteeism, overall work impairment, and activity impairment. All subscales range from zero to 100% with zero indicating no impairment and 100% indicating full impairment.
Baseline to 6 and 12 months
Consumer Health Activation Index (CHAI)
Ramy czasowe: Baseline to 6 and 12 months
The ten-item CHAI score ranges from 0 to 100, with higher scores indicating greater health activation. A score of 0 indicates the lowest level of health activation, while a score of 100 indicates the highest level of health activation.
Baseline to 6 and 12 months
Vitality (TARMO)
Ramy czasowe: Baseline to 6 and 12 months
One question with five levels. Range 1-5, 0ne indicates full vitality and five no vitality.
Baseline to 6 and 12 months
Self-rated health
Ramy czasowe: Baseline to 6 and 12 months
One question with five levels. Range 1-5, one indicate good health and 5 indicates poor health.
Baseline to 6 and 12 months
Net Promoter Score (NPS)
Ramy czasowe: Baseline to 6 and 12 months
NPS score is measured with a single-question survey and reported with a number ranging from -100 to +100, where a higher score is desirable.
Baseline to 6 and 12 months
New relevant prescriptions
Ramy czasowe: Over at least 12 months
Proportion of patients with new prescriptions for antidiabetic, antihypertensive, lipid-lowering, and renal protective drugs (Eloisa's EHR system, Kela medicine reimbursement register).
Over at least 12 months
Work absenteeism
Ramy czasowe: Over at least 12 months
Number of sickness allowance days (Eloisa's EHR system, Kela register).
Over at least 12 months
Work disability
Ramy czasowe: Over at least 12 months
Number of disability pension days (ETK register).
Over at least 12 months
Hospitalization
Ramy czasowe: Over at least 12 months
Number of all-cause and cause-specific hospitalization days (Eloisa's EHR system, Hilmo, THL).
Over at least 12 months
Primary care visit rates
Ramy czasowe: Over at least 12 months
Primary care visit rates (Eloisa's EHR system, AvoHilmo, THL)
Over at least 12 months
Completion of the digital pathway
Ramy czasowe: Baseline
Indicator (0/1) of digital pathway successfully initiated for the participant. Zero indicates not initiated and one successful initiation.
Baseline
Completion of blood sampling
Ramy czasowe: Baseline and 6 months
Indicator (0/1) of NMR blood sampling completed as planned for the participant. Zero indicates not completed and one successful completion.
Baseline and 6 months
Completion of risk-report delivery
Ramy czasowe: Baseline and 6 months
Indicator (0/1) of risk report successfully returned to the participant. Zero indicates no return and one successful return.
Baseline and 6 months
Correct intervention allocation relative to risk stratum
Ramy czasowe: Baseline
Indicator (0/1) of correct intervention allocation relative to risk stratum. Zero indicates false and one correct intervention allocation.
Baseline

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

Współpracownicy

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 września 2026

Zakończenie podstawowe (Szacowany)

1 września 2027

Ukończenie studiów (Szacowany)

1 marca 2028

Daty rejestracji na studia

Pierwszy przesłany

2 września 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

10 września 2026

Pierwszy wysłany (Rzeczywisty)

15 września 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

15 września 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

10 września 2026

Ostatnia weryfikacja

1 września 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • 189/2026

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Opis planu IPD

Plan to Share Individual Participant Data (IPD): Case-by-case. The full trial protocol (current version) will be deposited on the trial registry and in the Finnish national research data storage service (IDA) at the time of registration. Requests for data sharing beyond the deposited protocol will be considered by the Trial Steering Committee on a case-by-case basis, subject to GDPR compliance and Findata regulations. Results and publications: all primary and secondary results are intended for peer-reviewed open-access publication (CC BY 4.0), following ICMJE authorship criteria.

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

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