Effectiveness of Theory-Based Health Information Technology Interventions on Coronary Artery Disease Self-Management Behavior: A Clinical Randomized Waitlist-Controlled Trial.
Pei-Chen Hong, Kuan-Jung Chen, Yue-Cune Chang and 2 others
PMID 33844425WHAT IT FOUND
In 60 patients with coronary artery disease, a 3-month home blood pressure monitoring and telephone education program lowered systolic blood pressure and improved self-management and quality of life over usual care.
Key findings
01At 3 months, systolic blood pressure decreased significantly in the intervention group (baseline mean 137.73 ± 18.23, 3-month mean 130.47 ± 13.67) and did not significantly increase in the waitlist group (baseline mean 126.23 ± 14.01, 3-month mean 127.43 ± 9.77).
02From baseline to 3 months, Partners in Health self-management scores improved significantly in the intervention group (81.00 ± 9.43 to 88.47 ± 7.98) and slightly but not significantly in the waitlist group (80.13 ± 8.94 to 81.87 ± 8.08).
03Total quality-of-life scores improved significantly in the intervention group from baseline to 3 months (57.43 ± 5.70 to 60.67 ± 5.89) and nonsignificantly in the waitlist group (54.47 ± 7.92 to 55.47 ± 7.16).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 60 patients were enrolled, and the trial was done mainly at one medical center, so the results may not apply to other settings. The Health IT system required a landline phone, so patients without a landline were not included. Follow-up was only 6 months, and the waitlist design did not test long-term cardiovascular events. The 3-to-6-month quality-of-life changes coincided with COVID-19 home quarantine, which the authors say may have worsened quality of life. Most participants were male and married, and about half were retired, so applicability to other groups may be limited.
The easy way to misread this
Do not read the 3-month improvements as proof of long-term cardiovascular benefit. The trial only followed patients for 6 months, and the control group received the same program after 3 months, so it cannot show whether the effect lasts or prevents heart events.