Article

Efficient ways are needed to implement the secondary prevention (SP) of
coronary heart disease. Because few studies have investigated Web-based SP
programs, our aim was to determine the usefulness of a new Web-based
telemonitoring system, connecting patients provided with self-measurement devices
and care managers via mobile phone text messages, as a tool for SP. METHODS: A
single-blind, randomized controlled, clinical trial of 203 acute coronary
syndrome (ACS) survivors, was conducted at a hospital in Madrid, Spain. All
patients received lifestyle counseling and usual-care treatment. Patients in the
telemonitoring group (TMG) sent, through mobile phones, weight, heart rate, and
blood pressure (BP) weekly, and capillary plasma lipid profile and glucose
monthly. A cardiologist accessed these data through a Web interface and sent
recommendations via short message service. Main outcome measures were BP, body
mass index (BMI), smoking status, low-density lipoprotein-cholesterol (LDL-c),
and glycated hemoglobin Ac (HbAc). RESULTS: At 12-month followup, TMG patients
were more likely (RR = 1.4; 95% CI = 1.1-1.7) to experience improvement in
cardiovascular risk factors profile than control patients (69.6% vs 50.5%, P =
.010). More TMG patients achieved treatment goals for BP (62.1% vs 42.9%, P =
.012) and HbAc (86.4% vs 54.2%, P = .018), with no differences in smoking
cessation or LDL-c. Body mass index was significantly lower in TMG (-0.77 kg/m(2)
vs +0.29 kg/m(2), P = .005). CONCLUSIONS: A telemonitoring program, via mobile
phone messages, appears to be useful for improving the risk profile in ACS
survivors and can be an effective tool for secondary prevention, especially for
overweight patients.

Langue : ANGLAIS

Tiré à part : OUI