Samuel William David Merriel1, Verity Andrews2, Christopher Salisbury3. 1. Centre for Academic Primary Care, School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Clifton BS8 2PS, UK. Electronic address: sam@merriel.com.au. 2. Centre for Academic Primary Care, School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Clifton BS8 2PS, UK. Electronic address: Verity.andrews@bristol.ac.uk. 3. Centre for Academic Primary Care, School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Clifton BS8 2PS, UK. Electronic address: c.salisbury@bristol.ac.uk.
Abstract
OBJECTIVE: To assess the effectiveness of telehealth interventions in the primary prevention of cardiovascular disease in adult patients in community settings. METHODS: Systematic literature review of randomised controlled trials comparing the effectiveness of telehealth interventions to reduce overall cardiovascular disease (CVD) risk and/or to reduce multiple CVD risk factors compared with a non-telehealth control group was conducted in June 2013. Study quality was assessed using the Cochrane Risk of Bias tool. Fixed and random effects models were combined with a narrative synthesis for meta-analysis of included studies. RESULTS: Three of 13 included studies measured Framingham 10-year CVD risk scores, and meta-analysis showed no clear evidence of reduction in overall risk (SMD -0.37%, 95% CI -2.08, 1.33). There was weak evidence for a reduction in systolic blood pressure (SMD -1.22 mmHg 95% CI -2.80, 0.35) and total cholesterol (SMD -0.07 mmol/L 95% CI -0.19, 0.06). There was no change in High-Density Lipoprotein cholesterol or smoking rates. CONCLUSION: There is insufficient evidence to determine the effectiveness of telehealth interventions in reducing overall CVD risk. More studies are needed that consistently measure overall CVD risk, directly compare different telehealth interventions, and determine cost effectiveness of telehealth interventions for prevention of CVD.
OBJECTIVE: To assess the effectiveness of telehealth interventions in the primary prevention of cardiovascular disease in adult patients in community settings. METHODS: Systematic literature review of randomised controlled trials comparing the effectiveness of telehealth interventions to reduce overall cardiovascular disease (CVD) risk and/or to reduce multiple CVD risk factors compared with a non-telehealth control group was conducted in June 2013. Study quality was assessed using the Cochrane Risk of Bias tool. Fixed and random effects models were combined with a narrative synthesis for meta-analysis of included studies. RESULTS: Three of 13 included studies measured Framingham 10-year CVD risk scores, and meta-analysis showed no clear evidence of reduction in overall risk (SMD -0.37%, 95% CI -2.08, 1.33). There was weak evidence for a reduction in systolic blood pressure (SMD -1.22 mmHg 95% CI -2.80, 0.35) and total cholesterol (SMD -0.07 mmol/L 95% CI -0.19, 0.06). There was no change in High-Density Lipoprotein cholesterol or smoking rates. CONCLUSION: There is insufficient evidence to determine the effectiveness of telehealth interventions in reducing overall CVD risk. More studies are needed that consistently measure overall CVD risk, directly compare different telehealth interventions, and determine cost effectiveness of telehealth interventions for prevention of CVD.
Authors: Lora E Burke; Jun Ma; Kristen M J Azar; Gary G Bennett; Eric D Peterson; Yaguang Zheng; William Riley; Janna Stephens; Svati H Shah; Brian Suffoletto; Tanya N Turan; Bonnie Spring; Julia Steinberger; Charlene C Quinn Journal: Circulation Date: 2015-08-13 Impact factor: 29.690
Authors: Chris Salisbury; Clare Thomas; Alicia O'Cathain; Anne Rogers; Catherine Pope; Lucy Yardley; Sandra Hollinghurst; Tom Fahey; Glyn Lewis; Shirley Large; Louisa Edwards; Alison Rowsell; Julia Segar; Simon Brownsell; Alan A Montgomery Journal: BMJ Open Date: 2015-02-06 Impact factor: 2.692
Authors: Padraig Dixon; Sandra Hollinghurst; Louisa Edwards; Clare Thomas; Alexis Foster; Ben Davies; Daisy Gaunt; Alan A Montgomery; Chris Salisbury Journal: BJPsych Open Date: 2016-08-09