Interventions to reduce the impact of modifiable risk factors, such as hypercholesterolaemia, smoking, and overweight, have the potential to significantly decrease the cardiovascular disease burden. The majority of the global population is unaware of their own risk of developing cardiovascular disease. Parallel to the lack of awareness, a rise in obesity and diabetes is observed. e‑Health tools for lifestyle improvement have shown to be effective in changing unhealthy behaviour. In this study we report on the results of three different trials assessing the effectiveness of MyCLIC, an e‑Coaching lifestyle intervention tool.
From 2008 to 2016 we conducted three trials: 1) HAPPY NL: a prospective cohort study in the Netherlands, 2) HAPPY AZM: a prospective cohort study with employees of Maastricht UMC+ and 3) HAPPY LONDON: a single-centre, randomised controlled trial with asymptomatic individuals who have a high 10-year CVD risk.
HAPPY NL and HAPPY AZM showed that e‑Coaching reduced cardiovascular risk. Both prospective trials showed a 20–25% relative reduction in 10-year cardiovascular disease risk. A lesser effect was seen in the HAPPY LONDON trial. A low frequency of logins suggests a low degree of content engagement in the e‑Coaching group, which could be age related as the mean age of the participants in the HAPPY LONDON study was high.
e-Coaching using MyCLIC is a low cost and effective method to perform lifestyle interventions and has the potential to reduce the 10-year cardiovascular disease risk.
Naszay M, Stockinger A, Jungwirth D, Haluza D. Digital age and the public ehealth perspective: prevailing health app use among Austrian Internet users. Inform Health Soc Care. 2017;1–11. https://doi.org/10.1080/17538157.2017.1399131. CrossRefPubMed
Maruthur NM, Wang N‑Y, Appel LJ. Lifestyle interventions reduce coronary heart disease risk: results from the PREMIER trial. Circulation. 2009;119:2026–31. CrossRef
Yach D, Hawkes C, Gould C, Hofman KJ. The global burden of chronic diseases: Overcoming impediments to prevention and control. JAMA. 2004;291:2616–22. CrossRef
van den Brekel-Dijkstra K, Rengers AH, Niessen MAJ, de Wit NJ, Kraaijenhagen RA. Personalized prevention approach with use of a web-based cardiovascular risk assessment with tailored lifestyle follow-up in primary care practice – a pilot study. Eur J Prev Cardiol. 2015;23:544–51. CrossRef
Yusuf S, Hawken S, Ôunpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2018;364:937–52. CrossRef
Colkesen EB, Ferket BS, Tijssen JGP, Kraaijenhagen RA, van Kalken CK, Peters RJG. Effects on cardiovascular disease risk of a web-based health risk assessment with tailored health advice: a follow-up study. Vasc Health Risk Manag. 2011;7:67–74. CrossRef
van Gemert-Pijnen JEWC, Nijland N, van Limburg M, et al. A holistic framework to improve the uptake and impact of ehealth technologies. J Med Internet Res. 2011;13:e111. CrossRef
NHG. Cardiovasculair risicomanagement (Tweede herziening). Huisarts Wet. 2012;55:14–28.
Sturgiss E, Haesler E, Elmitt N, van Weel C, Douglas K. Increasing general practitioners’ confidence and self-efficacy in managing obesity: a mixed methods study. BMJ Open. 2017;7(1):e14314. CrossRef
Assmann G, Schulte H. The Prospective Cardiovascular Münster (PROCAM) study: prevalence of hyperlipidemia in persons with hypertension and/or diabetes mellitus and the relationship to coronary heart disease. Am Heart J. 2018;116:1713–24. CrossRef
Lloyd-Jones DM, Wilson PWF, Larson MG, et al. Framingham risk score and prediction of lifetime risk for coronary heart disease. Am J Cardiol. 2018;94:20–4. CrossRef
Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, May M, Brindle P. Derivation and validation of QRISK, a new cardiovascular disease risk score for the United Kingdom: prospective open cohort study. BMJ. 2007;335:136. CrossRef
Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by repr. Eur Heart J. 2012;33:1635–701. CrossRef
Wallis EJ, Ramsay LE, Jackson PR. Cardiovascular and coronary risk estimation in hypertension management. Heart. 2002;88:306–12. CrossRef
Lafeber M, Webster R, Visseren FLJ, et al. Estimated cardiovascular relative risk reduction from fixed-dose combination pill (polypill) treatment in a wide range of patients with a moderate risk of cardiovascular disease. Eur J Prev Cardiol. 2016;23:1289–97. CrossRef
Crebolder HFJM, van der Horst FG. Anticipatory care and the role of Dutch general practice in health promotion — a critical reflection. Patient Educ Couns. 2018;28:51–5. CrossRef
Werkgroep Cijfers. Hartstichting Jaarverslag 2016. 2016.
Sargeant J, Valli M, Ferrier S, MacLeod H. Lifestyle counseling in primary care: opportunities and challenges for changing practice. Med Teach. 2008;30:185–91. CrossRef
Carey M, Noble N, Mansfield E, Waller A, Henskens F, Sanson-Fisher R. The role of ehealth in optimizing preventive care in the primary care setting. J Med Internet Res. 2015;17(5):e126. CrossRef
Vigersky RA, Fitzner K, Levinson J, Group for the DW. Barriers and Potential Solutions to Providing Optimal Guideline-Driven Care to Patients With Diabetes in the U.S. Diabetes Care. 2013;36:3843–9. CrossRef
Peeters JM, Krijgsman JW, Brabers AE, De Jong JD, Friele RD. Use and uptake of ehealth in general practice: a cross-sectional survey and focus group study among healthcare users and general practitioners. JMIR Med Inform. 2016;4:e11. CrossRef
Norman GJ, Zabinski MF, Adams MA, Rosenberg DE, Yaroch AL, Atienza AA. A review of ehealth interventions for physical activity and dietary behavior change. Am J Prev Med. 2007;33:336–45. CrossRef
Wiersma T, Smulders YM, Stehouwer CD, Konings KTLJ. Summary of the multidisciplinary guideline on cardiovascular risk management (revision 2011). Ned Tijdschr Geneeskd. 2012;156:A510.
Hamet P, Tremblay J. Artificial intelligence in medicine. Metab Clin Exp. 2018;69:S36–S40. CrossRef
Barello S, Triberti S, Graffigna G, et al. ehealth for patient engagement: a systematic review. Front Psychol. 2015;6:2013. PubMed
Wilmer HH, Sherman LE, Smartphones Cognition CJM. A review of research exploring the links between mobile technology habits and cognitive functioning. Front Psychol. 2017;8:605. CrossRef
Simons LPA, Foerster F, Bruck PA, Motiwalla L, Jonker CM. Microlearning mApp raises health competence: hybrid service design. Health Technol. 2015;5:35–43. CrossRef
Anshari M, Almunawar MN. Mobile health (mhealth) services and Online health educators. Biomed Inform Insights. 2016;8:19–27. CrossRef
- Effectiveness of web-based personalised e‑Coaching lifestyle interventions
G. A. Somsen
I. I. Tulevski
- Bohn Stafleu van Loghum
Neu im Fachgebiet Kardiologie
Mail Icon II