Abstract
Purpose: In 2011 almost one third of all deaths in the Australian population were attributable to cardiovascular disease, of these 80% were preventable. Telephone coaching programs are flexible, multifaceted and integrated with the patient’s primary health care provider. This study aimed to measure changes in cardiovascular risk factors among patients with coronary heart disease (CHD) and/or type 2 diabetes enrolled in a centralised state-wide telehealth coaching program in the public health sector in Australia.
Methods: A population-based analysis of cardiovascular risk factor data collected prospectively as part of The COACH Program delivered through Government’s Health Contact Centre. Participants were patients with CHD (n = 1962) and type 2 diabetes (n = 707), of whom 145 were Indigenous. Changes in fasting lipids, fasting glucose, glycosylated haemoglobin (HbA1c), blood pressure, body weight, body mass index (BMI), waist circumference, alcohol consumption and physical activity, as measured at entry to, and completion of, the program were analysed using pair-wise comparison.
Results: Improvements in cardiovascular risk factor status, from entry to completion of the program, were found across all biomedical and lifestyle factors in patients with CHD and/or type 2 diabetes. For both diseases, reductions in serum lipids, blood glucose, smoking habit and alcohol consumption combined with increases in physical activity were the most notable findings. Those most clinically significant were: a decrease in mean LDL-cholesterol from 2.4 mmol/L to 1.8 mmol/L (CHD) and from 2.5 to 2.0 mmol/l (diabetes); a decrease in mean alcohol ingestion from 1.4 to 1.1 (CHD) and 1.3 to 0.9 (diabetes) standard drinks; and an increase in mean physical activity from 142 to 229 minutes (CHD) and from 127 to 182 minutes (diabetes) per week; and a decrease in mean HbA1c from 8.2% to 7.4% for diabetes patients (p<0.001 for all comparisons). Similar differences were found in mean change scores in cardiovascular risk factors between Indigenous and non-Indigenous participants.
Conclusion: A centralised state-wide telehealth coaching program overcomes obstacles of distance and limited access to health services and facilitates guideline concordant decrease in cardiovascular risk.
Methods: A population-based analysis of cardiovascular risk factor data collected prospectively as part of The COACH Program delivered through Government’s Health Contact Centre. Participants were patients with CHD (n = 1962) and type 2 diabetes (n = 707), of whom 145 were Indigenous. Changes in fasting lipids, fasting glucose, glycosylated haemoglobin (HbA1c), blood pressure, body weight, body mass index (BMI), waist circumference, alcohol consumption and physical activity, as measured at entry to, and completion of, the program were analysed using pair-wise comparison.
Results: Improvements in cardiovascular risk factor status, from entry to completion of the program, were found across all biomedical and lifestyle factors in patients with CHD and/or type 2 diabetes. For both diseases, reductions in serum lipids, blood glucose, smoking habit and alcohol consumption combined with increases in physical activity were the most notable findings. Those most clinically significant were: a decrease in mean LDL-cholesterol from 2.4 mmol/L to 1.8 mmol/L (CHD) and from 2.5 to 2.0 mmol/l (diabetes); a decrease in mean alcohol ingestion from 1.4 to 1.1 (CHD) and 1.3 to 0.9 (diabetes) standard drinks; and an increase in mean physical activity from 142 to 229 minutes (CHD) and from 127 to 182 minutes (diabetes) per week; and a decrease in mean HbA1c from 8.2% to 7.4% for diabetes patients (p<0.001 for all comparisons). Similar differences were found in mean change scores in cardiovascular risk factors between Indigenous and non-Indigenous participants.
Conclusion: A centralised state-wide telehealth coaching program overcomes obstacles of distance and limited access to health services and facilitates guideline concordant decrease in cardiovascular risk.
| Original language | English |
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| Publication status | Published - 14 Jun 2015 |
| Event | EuroHeartCare 2015 - Dubrovnik , Croatia Duration: 14 Jun 2015 → 15 Jun 2015 |
Conference
| Conference | EuroHeartCare 2015 |
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| Country/Territory | Croatia |
| City | Dubrovnik |
| Period | 14/06/2015 → 15/06/2015 |