Article
A virtual community of practice to improve the empowerment of patients with ischemic heart disease: a randomized controlled trial
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Authors
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Ana Isabel González-González
- Vice-Directorate for Health Research and Documentation. Directorate General for Research, Education and Innovation. Madrid Health Ministry, Innovation and International Projects Unit, Madrid, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
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Helena Vall-Roqué
- Universidad Autónoma de Barcelona, Avedis Donabedian Research Institute (FAD), Barcelona, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
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Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
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Débora Koatz
- Universidad Autónoma de Barcelona, Avedis Donabedian Research Institute (FAD), Barcelona, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
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Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
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Alexandra Torres
- Canary Islands Health Research Institute Foundation, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
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Patricia Cifuentes
- Fundación para la Investigación e Innovación Biosanitaria de Atención Primaria (FIIBAP), Spanien
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Anthea Santos
- Canary Islands Health Research Institute Foundation, Spanien
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Javier García-García
- Hospital U. Nuestra Señora de Candelaria, Unidad de Calidad y Seguridad del Paciente, Spanien
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Valeria Pacheco-Huergo
- Institut Català de la Salut, Centro de Atención Primaria Turó-Vilapicina, Spanien
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Lilisbeth Perestelo-Pérez
- Canary Islands Health Research Institute Foundation, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
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Carola Orrego
- Universidad Autónoma de Barcelona, Avedis Donabedian Research Institute (FAD), Barcelona, Spanien; Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spanien
| Published: | March 12, 2024 |
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Outline
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Background/research question: Virtual Communities of Practice (vCoP) provide valuable knowledge exchange, social support, and skills enhancement for individuals facing similar challenges. However, limited clinical evidence exists on their impact for chronic disease patients. This study aims to assess the effectiveness of a vCoP in enhancing patient activation in Ischemic Heart Disease (IHD) patients.
Methods: We conducted a randomized controlled trial involving patients with ischemic heart disease from Madrid, Catalonia, and the Canary Islands, participants were randomly assigned to either an intervention or control group. Patient data was anonymized, and the statistician was blinded to group allocation. The intervention comprised a tailored vCoP based on Web 2.0 principles, emphasizing skills related to patient empowerment [1]. The primary outcome measure was the Patient Activation Measure score, with secondary outcomes including attitudes toward disease, adherence to the Mediterranean diet, physical activity levels, depression, anxiety, medication adherence, and health-related quality of life. A linear regression model with mixed effects was used to estimate the impact of vCoP participation on these outcomes.
Results: In this study, 97 healthcare providers contacted 579 recently diagnosed IHD patients, of which 282 met inclusion criteria and participated. Follow-ups were conducted at 6, 12, and 18 months, with varying dropout rates observed in the Patient Activation Measure (PAM) between intervention and control groups. A subset of patients (23.97%) in the intervention group never accessed the virtual community of practice (vCoP), while among those who did, their level of physical activity (METs) correlated with vCoP usage. The intervention significantly improved Mediterranean Diet Adherence at 6, 12, and 18 months (B=0.86, 95%CI: 0.36, 1.35), but the impact on other variables was not as pronounced.
Conclusion: Our study found that a vCoP improved Mediterranean diet adherence over an 18-month period, aligning with the potential of digital health interventions. However, no significant effects were observed for other variables, possibly due to participant motivation and access to healthcare resources. While the study had strengths like its unique approach, it also faced limitations, including recruitment challenges and attrition. Future research should consider mixed methods studies and personalized interventions to enhance the effectiveness of vCoPs for cardiovascular patients.
Competing interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
- 1.
- Toledo-Chávarri A, Ramos-García V, Koatz D, Torres-Castaño A, Perestelo-Pérez L, Ramírez-Puerta AB, Tello-Bernabé ME, García-García JM, García-García J, Pacheco-Huergo V, Orrego C, González-González AI; e-mpodera group. Co-Design Process of a Virtual Community of Practice for the Empowerment of People with Ischemic Heart Disease. Int J Integr Care. 2020 Nov 9;20(4):9. DOI: 10.5334/ijic.5514.
