Internet Based Vascular Risk Factor Intervention and Self Management Study

NCT ID: NCT00785031

Last Updated: 2012-06-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

330 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2011-06-30

Brief Summary

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The objective of the study is to evaluate the efficacy and cost-effectiveness of an internet based vascular risk factor program on top of usual care compared to usual care alone for treatment of vascular risk factors in patients at high risk for new vascular events.

Detailed Description

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The objective of the study is to evaluate the efficacy and cost-effectiveness of an internet based vascular risk factor program on top of usual care compared to usual care alone for treatment of vascular risk factors in patients at high risk for new vascular events.

Study design: randomized non-blinded trial Study population: patients in the Rijnstate Hospital Arnhem and the UMC Utrecht, The Netherlands with a recent diagnosis of cerebral, cardiac or peripheral artery disease that entered the risk factor screening programs in these hospitals revealing 2 or more treatable risk factors.

Intervention: After the screening program patients will be randomized to usual care alone or to the internet program on top of usual care. Usual care for risk factor management will be delivered by the medical specialist and/or the general practitioner. Patients randomized to the internet based intervention program are first seen by the nurse practitioner on a regular clinic visit. The internet dossier is than created and explained to the patient. Subsequent contacts between nurse practitioner and patient about risk factor management is mainly by the internet. The nurse practitioner works according to the national guidelines for cardiovascular risk management ('CardioVascular Risico Management 2006') and is supervised by an internist. The study period is 1 year. All patients in both groups ware asked to return to the clinic for a follow up measurement of risk factors after 1 year.

Outcome measures: Primary outcome is the difference in Framingham heart risk score between baseline and after 1 year. As secondary outcome the percentage of patients achieving treatment goals for each risk factor and the average change in the absolute value of each risk factors after 1 year will be used.

Sample size calculation/data analysis: 380 patients. Changes in risk factors (absolute change and fraction of patients achieving treatment goal of each risk factor) at the start and after 1 year and between the groups are tested with independent sample t-test and Chi-square test.

Economic evaluation: The balance between costs and effects of the internet based vascular risk factor management program will be compared to usual care. Using a previously developed cardiovascular disease model incremental cost-utility analyses will be conducted with remaining life expectancy as the relevant time horizon.

Conditions

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Cardiovascular Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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internet based intervention

Group Type ACTIVE_COMPARATOR

internet based vascular risk factor intervention

Intervention Type OTHER

The patient and a nurse practitioner create an internet dossier and the patient is instructed on how to use the internet dossier. The internet dossier is mainly meant for the patient: to improve knowledge of vascular risk factors, to give an overview of the actual status of the levels of his/her vascular risk factors and to give guidance and personal advice how to treat risk factors with medication and/or lifestyle.

usual care

Patients receive their usual care from their specialist or general practitioner.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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internet based vascular risk factor intervention

The patient and a nurse practitioner create an internet dossier and the patient is instructed on how to use the internet dossier. The internet dossier is mainly meant for the patient: to improve knowledge of vascular risk factors, to give an overview of the actual status of the levels of his/her vascular risk factors and to give guidance and personal advice how to treat risk factors with medication and/or lifestyle.

Intervention Type OTHER

Other Intervention Names

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Disease management self management nurse practitioner internet risk factors primary care vascular diseases

Eligibility Criteria

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Inclusion Criteria

* Participation in a cardiovascular risk screening program
* 2 or more modifiable risk factors not on target:
* SBP \> 140 mmHg
* LDL-c \> 2.5 mmol/l
* Triglycerides \> 1.7 mmol/l
* BMI \> 25 kg/m2
* Diabetes Mellitus or fasting glucose \> 6.1 mmol/l
* Smoking

Exclusion Criteria

* No internet access at home
* Unable to read and write Dutch
* Dependent in in daily activities (Ranking score \>=3)
* Life expectancy \< 2 years or an active malignant disease
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rijnstate Hospital

OTHER

Sponsor Role collaborator

UMC Utrecht

OTHER

Sponsor Role lead

Responsible Party

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dr.Frank L.J. Visseren

Prof.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Frank Visseren, MD PhD

Role: PRINCIPAL_INVESTIGATOR

UMC Utrecht

Yolanda van der Graaf, MD PhD

Role: STUDY_CHAIR

Julius Center for Health Sciences and Primary Care

Ardine de Wit, MD PhD

Role: STUDY_CHAIR

Julius Center for Health Sciences and Primary Care

Karin Kaasjager, MD PhD

Role: STUDY_CHAIR

Rijnstate Hospital Arnhem

Locations

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Department of Vascular Medicine UMC Utrecht

Utrecht, Utrecht, Netherlands

Site Status

Rijnstate Hospital

Arnhem, , Netherlands

Site Status

Countries

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Netherlands

References

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Goessens BM, Visseren FL, de Nooijer J, van den Borne HW, Algra A, Wierdsma J, van der Graaf Y; SMART Study Group. A pilot-study to identify the feasibility of an Internet-based coaching programme for changing the vascular risk profile of high-risk patients. Patient Educ Couns. 2008 Oct;73(1):67-72. doi: 10.1016/j.pec.2008.06.004. Epub 2008 Jul 18.

Reference Type BACKGROUND
PMID: 18639410 (View on PubMed)

Goessens BM, Visseren FL, Sol BG, de Man-van Ginkel JM, van der Graaf Y; SMART Study Group. A randomized, controlled trial for risk factor reduction in patients with symptomatic vascular disease: the multidisciplinary Vascular Prevention by Nurses Study (VENUS). Eur J Cardiovasc Prev Rehabil. 2006 Dec;13(6):996-1003. doi: 10.1097/01.hjr.0000216549.92184.40.

Reference Type BACKGROUND
PMID: 17143135 (View on PubMed)

Sol BG, van der Graaf Y, van der Bijl JJ, Goessens BM, Visseren FL. The role of self-efficacy in vascular risk factor management: a randomized controlled trial. Patient Educ Couns. 2008 May;71(2):191-7. doi: 10.1016/j.pec.2007.12.005. Epub 2008 Feb 1.

Reference Type BACKGROUND
PMID: 18242934 (View on PubMed)

Sol BG, van der Graaf Y, van der Bijl JJ, Goessens NB, Visseren FL. Self-efficacy in patients with clinical manifestations of vascular diseases. Patient Educ Couns. 2006 Jun;61(3):443-8. doi: 10.1016/j.pec.2005.05.011. Epub 2005 Jul 11.

Reference Type BACKGROUND
PMID: 16009526 (View on PubMed)

Sol BG, van der Bijl JJ, Banga JD, Visseren FL. Vascular risk management through nurse-led self-management programs. J Vasc Nurs. 2005 Mar;23(1):20-4. doi: 10.1016/j.jvn.2004.12.003.

Reference Type BACKGROUND
PMID: 15741961 (View on PubMed)

Greving JP, Kaasjager HA, Vernooij JW, Hovens MM, Wierdsma J, Grandjean HM, van der Graaf Y, de Wit GA, Visseren FL. Cost-effectiveness of a nurse-led internet-based vascular risk factor management programme: economic evaluation alongside a randomised controlled clinical trial. BMJ Open. 2015 May 20;5(5):e007128. doi: 10.1136/bmjopen-2014-007128.

Reference Type DERIVED
PMID: 25995238 (View on PubMed)

Vernooij JW, Kaasjager HA, van der Graaf Y, Wierdsma J, Grandjean HM, Hovens MM, de Wit GA, Visseren FL; SMARTStudy Group. Internet based vascular risk factor management for patients with clinically manifest vascular disease: randomised controlled trial. BMJ. 2012 Jun 12;344:e3750. doi: 10.1136/bmj.e3750.

Reference Type DERIVED
PMID: 22692651 (View on PubMed)

Other Identifiers

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08-119/O

Identifier Type: OTHER

Identifier Source: secondary_id

80-00702-98-084 ZonMw

Identifier Type: -

Identifier Source: org_study_id

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