Yun Young Ho, Kang EunKyo, Cho Young Min, Park Sang Min, Kim Yong-Jin, Lee Hae-Young, Kim Kyae Hyung, Lee Kiheon, Koo Hye Yeon, Kim Soojeong, Rhee YeEun, Lee Jihye, Min Jeong Hee, Sim Jin-Ah
Seoul National University College of Medicine, Department of Family Medicine, Seoul, Republic of Korea.
Seoul National University College of Medicine, Department of Internal Medicine, Seoul, Republic of Korea.
J Med Internet Res. 2020 Jan 22;22(1):e15057. doi: 10.2196/15057.
In addition to medication, health behavior management is crucial in patients with multiple risks of cardiovascular mortality.
This study aimed to examine the efficacy of a 3-month Smart Management Strategy for Health-based electronic program (Smart Healthing).
A 2-arm randomized controlled trial was conducted to assess the efficacy of Smart Healthing in 106 patients with at least one indicator of poor disease control and who had hypertension, diabetes, or hypercholesterolemia. The intervention group (n=53) took part in the electronic program, which was available in the form of a mobile app and a Web-based PC application. The program covered 4 areas: self-assessment, self-planning, self-learning, and self-monitoring by automatic feedback. The control group (n=53) received basic educational material concerning disease control. The primary outcome was the percentage of participants who achieved their clinical indicator goal after 12 weeks into the program: glycated hemoglobin (HbA) <7.0%, systolic blood pressure (SBP) <140 mmHg, or low-density lipoprotein cholesterol <130 mg/dL.
The intervention group showed a significantly higher success rate (in comparison with the control group) for achieving each of 3 clinical indicators at the targeted goal levels (P<.05). Only the patients with hypertension showed a significant improvement in SBP from the baseline as compared with the control group (72.7% vs 35.7%; P<.05). There was a significant reduction in HbA in the intervention group compared with the control group (difference=0.54%; P≤.05). In the intervention group, 20% of patients with diabetes exhibited a ≥1% decrease in HbA (vs 0% among controls; P≤.05).
A short-term self-management strategy-based electronic program intervention may improve clinical outcomes among patients with cardiovascular risks.
ClinicalTrials.gov NCT03294044; https://clinicaltrials.gov/ct2/show/NCT03294044.
除药物治疗外，健康行为管理对有多种心血管疾病死亡风险的患者至关重要。
本研究旨在检验基于健康的3个月智能管理策略电子项目（智能健康）的疗效。
进行了一项双臂随机对照试验，以评估智能健康对106例至少有一项疾病控制不佳指标且患有高血压、糖尿病或高胆固醇血症患者的疗效。干预组（n=53）参与了该电子项目，该项目以移动应用程序和基于网络的个人电脑应用程序的形式提供。该项目涵盖4个领域：自我评估、自我规划、自我学习以及通过自动反馈进行自我监测。对照组（n=53）接受了有关疾病控制的基础教育材料。主要结局是在项目进行12周后达到其临床指标目标的参与者百分比：糖化血红蛋白（HbA）<7.0%、收缩压（SBP）<140 mmHg或低密度脂蛋白胆固醇<130 mg/dL。
干预组在达到3项临床指标各自的目标水平方面（与对照组相比）成功率显著更高（P<.05）。仅高血压患者的收缩压与对照组相比从基线水平有显著改善（72.7%对35.7%；P<.05）。与对照组相比，干预组的糖化血红蛋白有显著降低（差值=0.54%；P≤.05）。在干预组中，20%的糖尿病患者糖化血红蛋白降低≥1%（对照组为0%；P≤.05）。
基于短期自我管理策略的电子项目干预可能改善有心血管疾病风险患者的临床结局。
ClinicalTrials.gov NCT03294044；https://clinicaltrials.gov/ct2/show/NCT03294044 。
