The telephone lifestyle intervention 'Hartcoach' has modest impact on coronary risk factors: A randomised multicentre trial

Abstract

Background Unhealthy diets and inactivity are still common among patients with cardiovascular diseases. This study evaluates the effects of the telephonic lifestyle intervention 'Hartcoach' on risk factors and self-management in patients with recent coronary events. Design This was a randomised trial in five Dutch hospitals. Methods Patients (18-80 years), less than eight weeks after hospitalisation for acute myocardial infarction or (un)stable angina pectoris were randomised to the Hartcoach-group, who received telephonic coaching every four weeks for a period of six months (in addition to usual care), and a control group receiving usual care only. Simple random allocation was used (without relation to prior assignment). Measurements were taken by research nurses blinded for group allocation. Differences after six months of participation were compared using linear or logistic regression models with treatment-group and baseline score for the outcome under analysis as covariates, resulting in adjusted mean change (b). Results Altogether 374 patients were randomised (173 Hartcoach + usual care, 201 usual care only). Follow-up was obtained in 331 patients who still participated after six months. Hartcoach had significant favourable effects on body mass index (BMI) (b = -0.32; 95% CI:(-0.63- -0.003)), waist circumference (b = -1.71; 95% CI:(-2.73- -0.70)), physical activity (b = 15.08 (score); 95% CI:(0.13, 30.04)) daily intake of vegetables (b = 13.41; 95% CI:(1.10-25.71)), self-management (b = 0.11; 95% CI:(0.00-0.23)) and anxiety (b = -0.65; 95% CI:(-1.25- -0.06)). Hartcoach slightly increased the total number of risk scores on target (b = 0.45; 95% CI:(0.17-0.73)). Conclusions Hartcoach has modest impact on BMI, waist circumference, physical activity, intake of vegetables, self-management and anxiety. Therefore, it may be a useful maintenance programme in addition to usual care, to support patients with recent coronary events to improve self-management and reduce risk factors.