NMR Metabolomics-Based Risk Assessment and Stratified Digital Health Interventions in Middle-Aged Adults (PREMAP) (PREMAP)
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
Przegląd badań
Status
Status
Warunki
Warunki
Interwencja / Leczenie
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
Typ studiów
Zapisy (Szacowany)
Zapisy
Faza
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
Kontakt w sprawie studiów
- Nazwa: Janne Martikainen, PhD, Professor
- Numer telefonu: +3583552600
- E-mail: janne.martikainen@uef.fi
Kryteria uczestnictwa
Kryteria kwalifikacji
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
Akceptuje zdrowych ochotników
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
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Zapobieganie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Pojedynczy
Liczba ramion
Broń i interwencje
Grupa uczestników / ArmGrupa uczestników / Arm |
Interwencja / LeczenieInterwencja / Leczenie |
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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.
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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:
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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.
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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:
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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).
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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:
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Co mierzy badanie?
Podstawowe miary wyniku
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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NMR-derived disease-specific 10-year risk predictions
Ramy czasowe: Baseline to 6 months
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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)
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Baseline to 6 months
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The World Health Organization-Five Well-Being Index (WHO-5)
Ramy czasowe: Baseline to 6 months (primary); baseline to 12 months (secondary time point)
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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.
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Baseline to 6 months (primary); baseline to 12 months (secondary time point)
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Miary wyników drugorzędnych
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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EuroQoL 5-Dimension 5-Level (EQ-5D-5L)
Ramy czasowe: baseline and at 6 and 12 months
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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.
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baseline and at 6 and 12 months
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Incident diagnoses of the five target conditions
Ramy czasowe: Over at least 12 months
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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).
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Over at least 12 months
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Cost-effectiveness
Ramy czasowe: Over at least 12 months
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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
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Over at least 12 months
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Work Productivity and Activity Impairment - General Health (WPAI-GH)
Ramy czasowe: Baseline to 6 and 12 months
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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.
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Baseline to 6 and 12 months
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Consumer Health Activation Index (CHAI)
Ramy czasowe: Baseline to 6 and 12 months
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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.
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Baseline to 6 and 12 months
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Vitality (TARMO)
Ramy czasowe: Baseline to 6 and 12 months
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One question with five levels.
Range 1-5, 0ne indicates full vitality and five no vitality.
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Baseline to 6 and 12 months
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Self-rated health
Ramy czasowe: Baseline to 6 and 12 months
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One question with five levels.
Range 1-5, one indicate good health and 5 indicates poor health.
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Baseline to 6 and 12 months
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Net Promoter Score (NPS)
Ramy czasowe: Baseline to 6 and 12 months
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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.
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Baseline to 6 and 12 months
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New relevant prescriptions
Ramy czasowe: Over at least 12 months
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Proportion of patients with new prescriptions for antidiabetic, antihypertensive, lipid-lowering, and renal protective drugs (Eloisa's EHR system, Kela medicine reimbursement register).
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Over at least 12 months
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Work absenteeism
Ramy czasowe: Over at least 12 months
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Number of sickness allowance days (Eloisa's EHR system, Kela register).
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Over at least 12 months
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Work disability
Ramy czasowe: Over at least 12 months
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Number of disability pension days (ETK register).
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Over at least 12 months
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Hospitalization
Ramy czasowe: Over at least 12 months
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Number of all-cause and cause-specific hospitalization days (Eloisa's EHR system, Hilmo, THL).
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Over at least 12 months
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Primary care visit rates
Ramy czasowe: Over at least 12 months
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Primary care visit rates (Eloisa's EHR system, AvoHilmo, THL)
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Over at least 12 months
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Completion of the digital pathway
Ramy czasowe: Baseline
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Indicator (0/1) of digital pathway successfully initiated for the participant.
Zero indicates not initiated and one successful initiation.
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Baseline
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Completion of blood sampling
Ramy czasowe: Baseline and 6 months
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Indicator (0/1) of NMR blood sampling completed as planned for the participant.
Zero indicates not completed and one successful completion.
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Baseline and 6 months
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Completion of risk-report delivery
Ramy czasowe: Baseline and 6 months
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Indicator (0/1) of risk report successfully returned to the participant.
Zero indicates no return and one successful return.
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Baseline and 6 months
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Correct intervention allocation relative to risk stratum
Ramy czasowe: Baseline
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Indicator (0/1) of correct intervention allocation relative to risk stratum.
Zero indicates false and one correct intervention allocation.
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Baseline
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Współpracownicy i badacze
Sponsor
Sponsor
Współpracownicy
Współpracownicy
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Rozpoczęcie studiów
Zakończenie podstawowe (Szacowany)
Zakończenie podstawowe
Ukończenie studiów (Szacowany)
Ukończenie studiów
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Pierwszy wysłany
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia wysłana aktualizacja
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
- Choroby układu moczowo-płciowego
- Choroby układu hormonalnego
- Choroby mózgu
- Choroby ośrodkowego układu nerwowego
- Choroby Układu Nerwowego
- Choroby naczyniowe
- Choroby układu krążenia
- Procesy patologiczne
- Choroby układu moczowo-płciowego u mężczyzn
- Choroby nerek
- Choroby Urologiczne
- Choroby układu moczowo-płciowego kobiet
- Choroby układu moczowo-płciowego kobiet i powikłania ciąży
- Choroby serca
- Przewlekła choroba
- Atrybuty choroby
- Choroby metaboliczne
- Choroby Układu Pokarmowego
- Zaburzenia metabolizmu glukozy
- Cukrzyca
- Zawał
- Martwica
- Choroby wątroby
- Niewydolność nerek
- Niedokrwienie mięśnia sercowego
- Niedokrwienie
- Tłusta wątroba
- Stany patologiczne, oznaki i objawy
- Choroby żywieniowe i metaboliczne
- Uderzenie
- Cukrzyca typu 2
- Niealkoholowe stłuszczenie wątroby
- Niewydolność nerek, przewlekła
- Choroba wieńcowa
- Zaburzenia naczyniowo-mózgowe
- Zawał mięśnia sercowego
Inne numery identyfikacyjne badania
Inne numery identyfikacyjne badania
- 189/2026
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu IPD
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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