Purpose: Secondary prevention of coronary artery disease, self-management
behavior, and blood pressure control are important to cardiovascular event
prevention and promotion of quality of life (QOL), but they are underutilized.
The purpose of this study was to investigate the effects of a self-efficacy
theory–based
health information technology intervention implemented
through blood control and patient self-management.
Design: A clinical randomized waitlist-controlled
trial.
Methods: The study was conducted at a medical center in Taipei, Taiwan.
A total of 60 subjects were randomly assigned to either the immediate
intervention (experimental) group or the waitlist control group. The primary
endpoint was systolic blood pressure at 3 months; secondary end
points included self-management
behavior and QOL. Treatment for the
immediate intervention group lasted 3 months, while the waitlist control
group received routine care for the first 3 months, at which point they
crossed over to the intervention arm and received the same intervention
as the experimental group for another 3 months. Both groups were evaluated
by questionnaires and physiological measurements at both 3 and 6
months postadmission. The results were analyzed using generalized estimating
equations.
Results: Systolic blood pressure significantly improved for the intervention
group participants at 3 months, when there was also significant improvement
in self-management
behavior and QOL. There was no significant or
appreciable effect of time spent in the waitlist condition, with treatments
in the two conditions being similarly effective.
Conclusion: The use of a theory-based
health information technology
treatment compared with usual care resulted in a significant improvement
in systolic blood pressure, self-management
behavior, and QOL in patients
with coronary artery disease.
Clinical Relevance: This treatment would be a useful strategy for clinical
care of cardiovascular disease patients, improving their disease self-management.
It also may help guide further digital health care strategies
during the COVID-19
pandemic.
