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Testing an online self-management program for patients with CVR: an explorative RCT.

Puijk-Hekman, S., Gaal, B.G.I. van, Bredie, S.J., Nijhuis-van der Sanden M.W.G., Dulmen, S. van. Testing an online self-management program for patients with CVR: an explorative RCT. Journal of Advanced Nursing: 2016, 72(suppl. 1) 82. Abstract. 5th European Nursing Congress: 'Caring for older people: how can we do the right things right?' 4-7 oktober 2016, Rotterdam.
Background
Because of the large impact of cardiovascular risk (CVR), there is a growing interest in self-management for patients with CVR. To support self-management behavior for patients with CVR, an e-health self-management program has been developed. In this study, we will evaluate the feasibility of the ehealth self-management program and estimate important outcome measures in an explorative randomized controlled trial.

Objectives
The objectives of this study are:
1) to pilot test an e-health self-management support program for patients with CVR;
2) to explore effectiveness and effect size of the e-health selfmanagement selfmanagement support program;
3) identify outcome measures most likely to capture potential benefit;
4) evaluate continued participation or dropping out of the intervention;
5) explore nurses’ changing roles and activities in the light of e-health intervention.

Materials and methods
Mixed methods were used: an explorative randomized controlled trial with a 6 and 12 month follow-up from baseline and qualitative interviews at 12 months follow-up were held. 200 patients with cardiovascular risk, 18 years of age and older, ability to speak and read the Dutch language were eligible for inclusion. Patients were stratified for diagnoses randomized to the intervention or control group. All nurses at the outpatient clinics were included.

Intervention
The intervention consists of six modules and strategies to support the behavioural change and maintenance of self-management behaviour.

Outcome
We measured self-management behaviour (PAM-13), quality of life (Rand-36), illness perception((IPQ-causes of my illness), self-efficacy for coping with CVR in daily life, medication adherence (MMAS-8), and patient’s attitude to prescription medicines (BMQ), lifestyle for patients with CVR (FTND, AUDIT, IPAQ and DHD-index) and communication (PEPPI-5). The process of the intervention was evaluated on actual use and added value of the e-health self-management support program and dropping out of the intervention. Both patients and nurses were part of the evaluation. Patient’s characteristics will be assessed together with the baseline outcome measures, via an online questionnaire and medical file. Repeated measures will be executed at 6 months and 12 months after baseline. Semi-structured interviews will be executed with patients and nurses.

Results
The inclusion of CVR patients started in September 2015 and the follow-up will last 1 year. At this moment an amount of 100 patients are using the online program.

Conclusion
This study will provide insight into the potential effectiveness of the online self-management support program for CVR patients.