哈特蔻驰生活方式干预通过电话减少冠心病危险因素的效果：一项随机试验。
The effects of Hartcoach, a life style intervention provided by telephone on the reduction of coronary risk factors: a randomised trial.
机构信息
Netherlands institute for health services research, Utrecht, The Netherlands.
出版信息
BMC Cardiovasc Disord. 2012 Jun 26;12:47. doi: 10.1186/1471-2261-12-47.
BACKGROUND
Cardiovascular disease (CVD) is the leading cause of death worldwide. Secondary prevention is essential, but participation rates for cardiac rehabilitation are low. Furthermore, current programmes do not accomplish that patients with CVD change their lifestyle in a way that their individual risk factors for recurrent events decrease, therefore more effective interventions are needed. In this study, the effectiveness of the Hartcoach-programme, a telephonic secondary prevention program focussing on self management, is studied.
METHODS/DESIGN: A multicenter, randomised parallel-group study is being conducted. Participants are 400 patients with acute myocardial infarction (STEMI, NSTEMI,) and patients with chronic or unstable angina pectoris (IAP). Patients are recruited through the participating hospitals and randomly assigned to the experimental group (Hartcoach-programme plus usual care) or the control group (usual care).The Hartcoach-programme consists of a period of six months during which the coach contacts the patient every four to six weeks by telephone. Coaches train patients to take responsibility for the achievement and maintenance of the defined target levels for their particular individual modifiable risk factors. Target levels and treatment goals are agreed by the nurse and patient together. Data collection is blinded and occurs at baseline and after 26 weeks (post-intervention). Primary outcome is change in cardiovascular risk factors (cholesterol, body mass index, waist circumference, blood pressure, physical activity and diet). Secondary outcomes include chances in glucose, HbA1c, medication adherence, self-management and quality of life.
DISCUSSION
This study evaluates the effects of the Hartcoach-programme on the reduction of individual risk factors of patients with CVDs. Patients who are not invited to follow a hospital based rehabilitation programme or patients who are unable to adhere to such a programme, may be reached by this home based Hartcoach-programme. If positive results are found, the implementation of the Hartcoach-programme will be extended, having implications for the management of many people with CVD.
TRIAL REGISTRATION
NTR2388.
背景
心血管疾病（CVD）是全球范围内的主要死亡原因。二级预防至关重要，但心脏康复的参与率很低。此外，目前的方案并不能使 CVD 患者改变生活方式，从而降低其复发事件的个体风险因素，因此需要更有效的干预措施。在这项研究中，研究了电话二级预防计划 Hartcoach 计划的有效性，该计划侧重于自我管理。
方法/设计：正在进行一项多中心、随机平行组研究。参与者为 400 名急性心肌梗死（STEMI、NSTEMI）患者和慢性或不稳定型心绞痛（IAP）患者。通过参与医院招募患者，并随机分配到实验组（Hartcoach 计划加常规护理）或对照组（常规护理）。Hartcoach 计划包括六个月的时间，在此期间，教练每四到六周通过电话与患者联系一次。教练培训患者为实现和维持其特定个体可改变的风险因素的定义目标水平负责。护士和患者共同商定目标水平和治疗目标。数据收集是盲法的，在基线和 26 周后（干预后）进行。主要结果是心血管风险因素（胆固醇、体重指数、腰围、血压、体力活动和饮食）的变化。次要结果包括葡萄糖、HbA1c、药物依从性、自我管理和生活质量的变化。
讨论
本研究评估了 Hartcoach 计划对降低 CVD 患者个体风险因素的影响。未被邀请参加医院为基础的康复计划的患者或无法坚持此类计划的患者，可能会被这种基于家庭的 Hartcoach 计划所覆盖。如果发现积极的结果，将扩展 Hartcoach 计划的实施，这对许多 CVD 患者的管理具有重要意义。
试验注册
NTR2388。
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