Vitale stroomlijning door ICT

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Vitale stroomlijning door ICT

• Congres Vitaal Veranderen
• Platform Vitale Vaten
• 13-2-2009

J.W.P. Vernooij Arts-onderzoeker Vasculaire
geneeskunde UMC Utrecht
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Vital streamlining with ICT

• Large group of patients with high cardiovascular
  risk
• Majority suboptimal treatment
• Work to do!
• More effective treatment
• More efficient treatment
• Combining
• Self-management
• Risk factor management
• ICT

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Randomized controlled trials using a web-based
intervention influencing cardiovascular risk
factors

• 8 trials, 2003-2008
• Patients n 15-1128
• Follow up 12 weeks-12 months
• Reported changes in max 2 risk factors
• Very recent development
• Limited results small patient amounts, short
  follow-up
• No economic evaluation

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SPAIN
"Selfmanagement of vascular Patients Activated by
Internet and Nurses".
Goessens, Visseren, de Nooijer, van den Borne,
Algra, Wierdsma, der Graaf, for the SMART Study
Group
Goessens 2008, Patient Educ Couns
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SPAIN methods

• Inclusion
• Patients from the SMART screening after a
  cardiovascular event
• Internet access
• Minimal 2 modifiable risk-factors
• Sample size
• 50 patients
• Outcome
• Controlled risk-factors after 1 year
  intervention vs. usual care
• Hypertension, hyperlipemia, dyslipemia,
  hyperglycaemia, overweight, smoking
• ? Framingham risk score

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SPAIN Intervention
Mijn SPAIN
SPAIN
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SPAIN Intervention
SPAIN
SPAIN
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SPAIN baseline
Goessens 2008, Patient Educ Couns
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SPAIN results
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Hypothesis

• How effective is an internet-based vascular risk-
  factor management program on top of usual care
  compared to usual care alone in reducing vascular
  risk-factors in patients with a recent clinical
  manifestation of a vascular disease?
• What are the costs and quality of life per
  life-year gained by an internet-based vascular
  risk factor management program?

IRIS Internet-based vascular Riscfactor
Intervention and Selfmanagement study Clinical
trials NCT00785031
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IRIS Methods

• Randomized controlled multi-centre trial
• Inclusion
• Patients after a cardiovascular event
• Minimal 2 modifiable risk-factors
• Sample size
• 380 patients in 2 centres (UMC Utrecht, Alysis
  Arnhem)
• Re-evaluation risk-factors after 1 year
• Hypertension, dyslipidemia, hyperglycaemia,
  overweight, smoking
• Questionnaires QOL, (in-)ability to work,
  health-care use
• Quality-of-life, health-care costs, economic costs

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IRIS Timelines

• 04-2008 METC application
• 10-2008 METC approval
• First patient in
• 11-2009 Last patient in
• 11-2010 Last patient out
• 01-2011 Data presentation

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IRIS study group
Hella Grandjean
Sabine Roos
Marian Seger
Astrid Punt
Dicky van Koten
Karin Kaasjager
Marcel Hovens
Dennis de Bie
Berna Sol
Sophie Hickox
Judith Wierdsma
Frank Visseren
Joris Vernooij
Julius Centrum
Ardine de Wit
Yolanda van der Graaf
Alexander Geerts
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