Clinical trial of an Internet-based case management system for secondary prevention of heart disease - PubMed (original) (raw)
Clinical Trial
Clinical trial of an Internet-based case management system for secondary prevention of heart disease
Barbara H Southard et al. J Cardiopulm Rehabil. 2003 Sep-Oct.
Abstract
Purpose: Despite demonstrated benefits of cardiac rehabilitation and risk factor reduction, only 11% to 38% of eligible patients with cardiovascular disease (CVD) participate in cardiac rehabilitation programs. Women and older adults are particularly less likely to participate in cardiac rehabilitation. In an effort to broaden access to cardiac rehabilitation, the authors developed an alternative Internet-based program that allows nurse case managers to provide risk factor management training, risk factor education, and monitoring services to patients with CVD.
Methods: The evaluation consisted of a randomized, clinical trial involving 104 patients with CVD, 53 of whom used the program as a special intervention (SI) for 6 months and 51 of whom received usual care (UC).
Results: The results indicate that fewer cardiovascular events occurred among the SI subjects (15.7%) than among the UC subjects (4.1%) (P =.053), resulting in a gross cost savings of 1418USdollarsperpatient.Withaprojectedprogramcostof1418 US dollars per patient. With a projected program cost of 1418USdollarsperpatient.Withaprojectedprogramcostof453 USD per patient, the return on investment is estimated at 213%. More weight loss occurred in the SI group (-3.68 pounds) than in the UC group (+.47 pounds) (P =.003). The differences between the two groups in terms of blood pressure, lipid levels, depression scores, minutes of exercise, and dietary habits were not statistically significant.
Conclusion: An Internet-based case management system could be used as a cost-effective intervention for patients with CVD, either independently or in conjunction with traditional cardiac rehabilitation.
Comment in
- New methods of delivering secondary preventive services: the promise of the Internet.
Gordon NF. Gordon NF. J Cardiopulm Rehabil. 2003 Sep-Oct;23(5):349-51. doi: 10.1097/00008483-200309000-00004. J Cardiopulm Rehabil. 2003. PMID: 14512779 No abstract available. - Addressing the problem of cardiac rehabilitation program distribution.
Gavic AM. Gavic AM. J Cardiopulm Rehabil. 2005 Mar-Apr;25(2):85-7. doi: 10.1097/00008483-200503000-00007. J Cardiopulm Rehabil. 2005. PMID: 15818196 No abstract available.
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