Internet-based interventions for the secondary prevention of coronary heart disease

Record type Uncertainties identified in research recommendations
Source Cochrane Heart Group
Why is there uncertainty? Reliable up-to-date systematic reviews have revealed important continuing uncertainties about treatment effects

Original Uncertainty

Implications for Research The current evidence on the use of the Internet in the secondary prevention of heart disease is still evolving and has shown mixed results. A number of questions have been raised. We particularly need to investigate the long-term effects of web-based interventions used in the secondary prevention of CHD on cardiovascular risk factor profiles and clinical events. There is also a need to determine the intensity and duration of the intervention required to achieve effective secondary prevention of CHD and the effective components of behavioural changes. With regards to the socio-demographic characteristics of the CHD population, future studies should focus interventions on a wide range of participants so that findings are generalisable and can also be tailored to specific populations if differences are found. More rigorous studies comparing the long-term effects of Internet interventions are needed in order to determine long-term effectiveness of Internet interventions for the secondary prevention of CHD. There is also a need to measure outcomes objectively. Physical activity was assessed using self report measures in six out of eight trials. These measures are susceptible to overestimations, which the use of accelerometer technology would reduce. Future trials should also include cost-effectiveness outcomes.


References to reliable up-to-date systematic reviews:

Devi R, Singh SJ, Powell J, Fulton EA, Igbinedion E, Rees K. Internet-based interventions for the secondary prevention of coronary heart disease. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD009386. DOI: 10.1002/14651858.CD009386.pub2

What is needed? Further research
Systematic reviews that need updating or extending None identified
Systematic reviews in preparation None identified
Ongoing controlled trials Improving coronary heart disease self-management using mobile technologies (TEXT4HEART) [See web page] Long-term effectiveness of a comprehensive cardiac telerehabilitation program (Telerehab III): a randomised controlled trial ISRCTN29243064 How to enhance physical activity after cardiac rehabilitation? A randomised controlled study comparing two follow-up training exercise programs NCT02228603

Classification

Which health conditions? Cardiovascular diseases | Heart disease
What is person's age? Adult
Which types of treatments? Diet | Education and training | Environmental | Exercise | Mixed or complex | Psychological therapy

Which Outcomes

Change in coronary heart disease symptoms, or change in management of symptoms (all-cause mortality, cardiovascular mortality, incidences of non-fatal re-infarction, change in cardiovascular risk factors); adverse effects or complications; patient satisfaction; health related quality of life; service related issues; and health related cost


Record ID: Publication date:10 Mar 2016
Last reviewed date:10 Mar 2017 Publication Type:Known Uncertainty
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