Efficacy of a nurse-led email reminder program for cardiovascular prevention risk reduction in hypertensive patients: a randomized controlled trial.

G Cicolini, V Simonetti, D Comparcini, I Celiberti, M Di Nicola, L M Capasso, M E Flacco, M Bucci, A Mezzetti, L Manzoli

Journal: International journal of nursing studies 2015;51(6):833-43

PMID: 24225325

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

Many strategies have been evaluated to improve the prevention and control of cardiovascular (CVD) risk factors. Nursing telephonic and tele-counseling individualized lifestyle educational programs have been found to improve blood pressure control and adherence to lifestyle recommendation. This study tested the efficacy of a nurse-led reminder program through email (NRP-e) to improve CVD risk factors among hypertensive adults.

METHODS

All participants received usual CVD prevention and a guideline-based educational program. Subjects in the NRP-e group also received weekly email alerts and phone calls from a nurse care manager for 6 months. Emails contained a reminder program on the need for adherence with a healthy lifestyle based upon current guidelines. Follow-up visits were scheduled at 1, 3 and 6 months after enrollment; randomization was made centrally and blood samples were evaluated into a single laboratory.

RESULTS

The final sample consisted of 98 (control) and 100 (NRP-e) subjects (mean age 59.0 ± 14.5 years; 51.0% males). After 6 months, the following CVD risk factors significantly improved in both groups: body mass index, alcohol and fruit consumption, cigarette smoking, adherence to therapy hours, systolic and diastolic blood pressure, fasting blood glucose, low-density lipoproteins (LDL) and total cholesterol, triglycerides, and physical activity. In the NRP-e group, however, the prevalence of several behaviors or conditions at risk decreased significantly more than in the control group: obesity (-16%), low fruit consumption (-24%), uncontrolled hypertension (-61%), LDL (-56%), and total cholesterol (-40%).

CONCLUSIONS

The NRP-e improved a range of CVD risk factors. The program had low costs, required only an average of <20 min per day in addition to normal practice, and may deserve further evaluation for the inclusion among existing care management approaches.

Address: ASL 02 Abruzzo, Italy; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Hospital of Matera, Italy. Electronic address: [email protected].; Department of Biomedical Science Laboratory of Biostatistic, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].; Department of Medicine and Science of Aging, "G. d'Annunzio" University of Chieti, Italy. Electronic address: [email protected].

DOI: 10.1016/j.ijnurstu.2013.10.010

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MeSH Terms: Aged, Cardiovascular Diseases, Electronic Mail, Female, Humans, Hypertension, Male, Middle Aged, Patient Compliance, Practice Patterns, Nurses', Reminder Systems, Risk Reduction Behavior