A pilot-study to identify the feasibility of an Internet-based coaching programme for changing the vascular risk profile of high-risk patients
Abstract
Objective To evaluate the feasibility of a web-based coaching programme for vascular risk factor treatment, to describe the patterns of use and to measure changes in risk factors.Methods Patients with a clinical manifestation of arterial disease and Internet access were asked to participate in the nurse-led Internet-based risk factor management programme. At the first clinic visit, a personalized action plan was made for the treatment of risk factors. Patients were instructed on communication with a specialized nurse through Internet and encouraged to enter self-measured risk factor levels at their personalized website. The nurse practitioner replied on working days and gave feedback, support, and recommendations on lifestyle and medical treatment. After 6 months, risk factors were re-measured.Results Fifty patients participated, 70% were overweight, 64% had hypertension, 42% hyperlipidemia, and 24% smoked at baseline. During 6 months, the log-in average at the individual website was 35 times per patient (1.3 log-ins/week); while the nurse practitioner logged-in at the overall website 23 times/week. The website was hardly used by five patients. Most e-mail messages were sent by patients for hypertension (211 times) and obesity (203 times), whereas the nurse practitioner sent nearly twice as many e-mail messages for hypertension (400 times) and obesity (455 times). The level of most risk factors decreased and the fraction of achieved treatment goals increased (blood pressure from 36 to 58%, LDL-cholesterol from 58 to 64%, glucose from 64 to 82%).Conclusions A web-based vascular risk factor intervention programme is feasible; it is frequently used by patients and suitable to decrease the level of several risk factors. It has the promise of being an efficacious intervention for risk factor sanitation in patients with symptomatic vascular disease.Practice implications An Internet-based individualised risk management programme could make patients aware of their self-management capability and may contribute to risk factor reduction.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Many trials use pilots and usability studies to ensure the program functions as planned.
“Many trials use pilots and usability studies to ensure the program functions as planned [18-22].”
From A Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies (2011) · cites this paper as [20]
Cites
(2000) · New England Journal of Medicine · doi:10.1056/nejm200001203420301 · Cited by 8,663 · see citing works
Collaboration, A. T. (2002) · BMJ · doi:10.1136/bmj.324.7329.71 · Cited by 6,943 · see citing works
Patient Self-management of Chronic Disease in Primary Care
Bodenheimer, T. (2002) · JAMA · doi:10.1001/jama.288.19.2469 · Cited by 3,598 · cited 1× · see citing works
“Therefore, action plans in short- and long-termare the central feature of self-management [24], these should be realistic and propose behaviour that patients are confident they can accomplish.”
BackgroundSelf-management approaches for people with chronic conditions: a review
Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(02)00032-0 · Cited by 2,800 · see citing works
De Backer, G. (2003) · European Heart Journal · doi:10.1016/s0195-668x(03)00347-6 · Cited by 2,251 · see citing works
Bhatt, D. L. (2006) · JAMA · doi:10.1001/jama.295.2.180 · Cited by 1,628 · see citing works
EUROPEAN GUIDELINES ON CARDIOVASCULAR DISEASE PREVENTION IN CLINICAL PRACTICE
Backer, D. D., Амбросиони, Е., Borch‐Johnsen, K., Brotons, C., Cífková, R., Dallongeville, J., Ebrahim, S. B. J., Færgeman, O., Graham, I. D., Mancia, G., et al. (2005) · Rational Pharmacotherapy in Cardiology · doi:10.20996/1819-6446-2005-1-3-57-65 · Cited by 1,268 · see citing works
Wantland, D. J., Portillo, C. J., Holzemer, W. L., Slaughter, R., & McGhee, E. M. (2004) · Journal of Medical Internet Research · doi:10.2196/jmir.6.4.e40 · Cited by 966 · see citing works
Klein, S., Burke, L. E., Bray, G. A., Blair, S., Allison, D. B., Pi-Sunyer, X., Hong, Y., & Eckel, R. H. (2004) · Circulation · doi:10.1161/01.cir.0000145546.97738.1e · Cited by 934 · see citing works
National Study of Physician Awareness and Adherence to Cardiovascular Disease Prevention Guidelines
Mosca, L., Linfante, A. H., Benjamin, E. J., Berra, K., Hayes, S. N., Walsh, B. W., Fabunmi, R. P., Kwan, J., Mills, T., & Simpson, S. L. (2005) · Circulation · doi:10.1161/01.cir.0000154568.43333.82 · Cited by 757 · see citing works
Interactive Health Communication Applications for people with chronic disease
Murray, E., Burns, J., See Tai, S., Lai, R., & Nazareth, I. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004274.pub4 · Cited by 722 · see citing works
Kroeze, W., Werkman, A., & Brug, J. (2006) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm3103_2 · Cited by 570 · see citing works
Wilson, K., Gibson, N., Willan, A., & Cook, D. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.7.939 · Cited by 415 · see citing works
Second Manifestations of ARTerial disease (SMART) study: Rationale and design
Simons, P. C. G., Algra, A., van der Laak, M. F., Grobbee, D. E., & van der Graaf, Y. (1999) · European Journal of Epidemiology · doi:10.1023/a:1007621514757 · Cited by 366 · see citing works
Self-citationMurchie, P., Campbell, N. C., Ritchie, L. D., Simpson, J. A., & Thain, J. (2003) · BMJ · doi:10.1136/bmj.326.7380.84 · Cited by 272 · see citing works
Jolly, K. B., Bradley, F., Sharp, S. J., Smith, H. E., Thompson, S. G., Kinmonth, A. L., & Mant, D. (1999) · BMJ · doi:10.1136/bmj.318.7185.706 · Cited by 235 · see citing works
Clinical Trial of an Internet-based Case Management System for Secondary Prevention of Heart Disease
Southard, B. H., Southard, D. R., & Nuckolls, J. (2003) · Journal of Cardiopulmonary Rehabilitation · doi:10.1097/00008483-200309000-00003 · Cited by 216 · see citing works
Murray, E. J., Burns, J., Tai, S. S., Lai, R., & Nazareth, I. (2005) · UCL Discovery (University College London) · Cited by 171 · see citing works
Nguyen, H. Q., Carrieri-Kohlman, V., Rankin, S. H., Slaughter, R., & Stulbarg, M. S. (2004) · Computers in Biology and Medicine · doi:10.1016/s0010-4825(03)00046-5 · Cited by 147 · see citing works
Pilot study of a Web-based compliance monitoring device for patients with congestive heart failure
Artinian, N. T., Harden, J. K., Kronenberg, M. W., Vander Wal, J. S., Daher, E., Stephens, Q., & Bazzi, R. I. (2003) · Heart & Lung · doi:10.1016/s0147-9563(03)00026-8 · Cited by 139 · see citing works
McDermott, M. M., Mandapat, A. L., Moates, A., Albay, M., Chiou, E., Celic, L., & Greenland, P. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.18.2157 · Cited by 135 · see citing works
Electronic Alerts Versus On-Demand Decision Support to Improve Dyslipidemia Treatment
van Wyk, J. T., van Wijk, M. A. M., Sturkenboom, M., Mosseveld, M., Moorman, P. W., & van der Lei, J. (2008) · Circulation · doi:10.1161/circulationaha.107.697201 · Cited by 124 · see citing works
Interactive Health Communication Applications for people with chronic disease
Murray, E., Burns, J., Tai, S. S., Lai, R., & Nazareth, I. (2004) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004274.pub3 · Cited by 112 · see citing works
Cupples, M., & Mcknight, A. (1999) · BMJ · doi:10.1136/bmj.319.7211.687 · Cited by 81 · see citing works
Umefjord, G., Hamberg, K., Malker, H., & Petersson, G. (2006) · Family Practice · doi:10.1093/fampra/cmi117 · Cited by 76 · see citing works
Vascular risk management through nurse-led self-management programs
Sol, B. G. M., van der Bijl, J. J., Banga, J.-D., & Visseren, F. L. J. (2005) · Journal of Vascular Nursing · doi:10.1016/j.jvn.2004.12.003 · Cited by 68 · see citing works
Self-citationBarriers to effective implementation of guideline recommendations
Erhardt, L. (2005) · The American Journal of Medicine · doi:10.1016/j.amjmed.2005.09.004 · Cited by 49 · see citing works
Kuhl, E. A., Sears, S. F., & CONTI, J. B. (2006) · Heart & Lung · doi:10.1016/j.hrtlng.2006.02.004 · Cited by 48 · see citing works
Telehealth as a Tool for Enhancing Care for Patients With Cardiovascular Disease
Artinian, N. T. (2007) · The Journal of Cardiovascular Nursing · doi:10.1097/00005082-200701000-00004 · Cited by 46 · see citing works
Castaldo, J., Nester, J., Wasser, T., Masiado, T., Rossi, M., Young, M., Napolitano, J. J., & Schwartz, J. S. (2005) · Disease Management · doi:10.1089/dis.2005.8.93 · Cited by 38 · see citing works
Goessens, B. M. B., Visseren, F. L. J., Sol, B. G. M., Ginkel, J. M. D. M., & van der Graaf, Y. (2006) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1097/01.hjr.0000216549.92184.40 · Cited by 34 · see citing works
Self-citationvan Wyk, J. T., van Wijk, M. A. M., Sturkenboom, M., Moorman, P. W., & van der Lei, J. (2005) · CHEST Journal · doi:10.1378/chest.128.4.2521 · Cited by 32 · see citing works
Knowledge for health care practice: A guide to using research evidence
Zalon, M. L. (1999) · Research in Nursing & Health · doi:10.1002/(sici)1098-240x(199912)22:6 · Cited by 31 · see citing works
Increasing Internet use among cardiovascular patients: new opportunities for heart health promotion.
Wong, B. M., Yung, B. M., Wong, A. L. Y., Chow, C.-M., & Abramson, B. L. (2005) · PubMed · Cited by 19 · see citing works
Flagged first, then by citations
1 of the 36 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Persuasive System Design Does Matter: a Systematic Review of Adherence to Web-based Interventions
Kelders, S. M., Kok, R. N., Ossebaard, H. C., & Van Gemert-Pijnen, J. E. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.2104 · Cited by 1,308 · see citing works
“Although 33 studies that are included in this review state that they have planned for adherence, it is remarkable that 18 state that encouraging adherence is a task for the counselor [45-62] and one study included monetary incentives to promote adherence [63].”
BackgroundA Systematic Review of the Impact of Adherence on the Effectiveness of e-Therapies
Donkin, L., Christensen, H., Naismith, S. L., Neal, B., Hickie, I. B., & Glozier, N. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1772 · Cited by 876 · see citing works
Burke, L. E., Ma, J., Azar, K. M. J., Bennett, G. G., Peterson, E. D., Zheng, Y., Riley, W., Stephens, J., Shah, S. H., Suffoletto, B., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000232 · Cited by 516 · see citing works
Widmer, R. J., Collins, N. M., Collins, C. S., West, C. P., Lerman, L. O., & Lerman, A. (2015) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2014.12.026 · Cited by 416 · see citing works
Chronic Health Conditions and Internet Behavioral Interventions
Schubart, J. R., Stuckey, H. L., GANESHAMOORTHY, A., & Sciamanna, C. (2011) · CIN Computers Informatics Nursing · doi:10.1097/ncn.0b013e3182155274 · Cited by 154 · see citing works
SCHUBART, J. R., STUCKEY, H. L., GANESHAMOORTHY, A., & SCIAMANNA, C. N. (2011) · CIN: Computers, Informatics, Nursing · doi:10.1097/ncn.0b013e3182065eed · Cited by 135 · see citing works
How do nurse practitioners work in primary health care settings? A scoping review
Grant, J. M., Lines, L. E., Darbyshire, P., & Parry, Y. (2017) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2017.06.011 · Cited by 118 · see citing works
“, 2013) or the presence lifestyle risk factors for chronic disease (Speck et al., 2007; Goessens et al., 2008; Stines et al., 2011; Ter Bogtr et al., 2011; Barte et al., 2012; Allen et al., 2014; Jarl et al., 2014), nurse practitioners worked with populations who were considered vulnerable.”
BackgroundInfluentialCicolini, G., Simonetti, V., Comparcini, D., Celiberti, I., Nicola, M. D., Capasso, L., Flacco, M. E., Bucci, M., Mezzetti, A., & Manzoli, L. (2013) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2013.10.010 · Cited by 110 · see citing works
“In addition, new strategies of computer-based intervention, which focused on self-management education, were found to be more beneficial for risk factor reduction in secondary CVD prevention (Goessens et al., 2008).”
Internet-based interventions for the secondary prevention of coronary heart disease
Devi, R., Singh, S., powell, J. A., Fulton, E. A., Igbinedion, E., & Rees, K. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009386.pub2 · Cited by 82 · see citing works
Vernooij, J. W. P., Kaasjager, K. A. H., van der Graaf, Y., Wierdsma, J. M., Grandjean, H. M. H., Hovens, M. M. C., de Wit, G. A., Visseren, F. L. J., & on behalf of the SMART study group (2012) · BMJ · doi:10.1136/bmj.e3750 · Cited by 74 · see citing works
Self-citationFactors Affecting Acceptance of Smartphone Application for Management of Obesity
Jeon, E., & Park, H. (2015) · Healthcare Informatics Research · doi:10.4258/hir.2015.21.2.74 · Cited by 74 · see citing works
“To control obesity, it is important to help the patient to control his/her weight over the long term, taking into account the obesity level and treatment demands of the individual [10].”
BackgroundLisón, J. F., Palomar, G., Mensorio›, M. S., Baños, R., Cebolla, A., Botella, C., Benavent-Caballer, V., & Rodilla, E. (2020) · Journal of Medical Internet Research · doi:10.2196/14196 · Cited by 69 · see citing works
“These patients need to develop specific self-management skills so that they can make long-lasting lifestyle changes and adhere to their treatments; however, clinics may not be an ideal environment for them because these surroundings can be perceived as intrusive and threatening [10,11].”
Online Patient Education for Chronic Disease Management: Consumer Perspectives
Win, K. T., Hassan, N. M., B, H. O.-K. A., & Probst, Y. (2016) · Journal of Medical Systems · doi:10.1007/s10916-016-0438-0 · Cited by 50 · see citing works
“Patient Tailored Information (5 items) Information tailored to patient’s symptoms [4, 80]”
BackgroundCastelijns, M. C., Helmink, M. A. G., Hageman, S. H. J., Asselbergs, F. W., de Borst, G. J., Bots, M. L., Cramer, M. J., Dorresteijn, J. A. N., Emmelot‐Vonk, M. H., Geerlings, M. I., et al. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-066952 · Cited by 47 · see citing works
Self-citationPrimary and Secondary Prevention of Cardiovascular Disease
Pietrzak, E. R., Cotea, C., & Pullman, S. (2014) · Journal of Cardiopulmonary Rehabilitation and Prevention · doi:10.1097/hcr.0000000000000063 · Cited by 45 · see citing works
Development of a Smartphone Application for Clinical-Guideline-Based Obesity Management
Jeon, E., & Park, H. (2015) · Healthcare Informatics Research · doi:10.4258/hir.2015.21.1.10 · Cited by 37 · see citing works
“To control obesity, individuals need interventions that can help them to continuously control their weight [3] rather than short-term education or intervention programs focused on specific factors.”
BackgroundEtminani, K., Engström, A. T., Göransson, C., Sant’Anna, A., & Nowaczyk, S. (2020) · Journal of Medical Internet Research · doi:10.2196/17201 · Cited by 39 · see citing works
Brough, C., Boyce, S., Houchen‐Wolloff, L., Sewell, L., & Singh, S. J. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3027 · Cited by 34 · see citing works
“Self-monitoring is particularly beneficial as it has been shown to help increase an individual’s awareness of their condition [43], thus allowing them to take better control of their condition.”
Understanding adherence to web-based interventions
Kelders, S. M. (2012) · doi:10.3990/1.9789036534178 · Cited by 29 · see citing works
Evaluation of the Effectiveness of Nurse Coaching in Improving Health Outcomes in Chronic Conditions
Vincent, A. E., & Sanchez-Birkhead, A. (2013) · Holistic Nursing Practice · doi:10.1097/hnp.0b013e31828a095c · Cited by 18 · see citing works
Oranta, O., Luutonen, S. H., Salokangas, R. K. R., Vahlberg, T. J., & Leino‐Kilpi, H. (2011) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2011.03798.x · Cited by 15 · see citing works
Smart technologies for older people
Morris, M. E. (2012) · Cited by 13 · see citing works
Vardanjani, S. A. E., Fanisaberi, L., Shahraki, F. A., Khalilzadeh, A., Vardanjani, A. T., & Dehkordi, F. G. (2013) · Nursing Research and Practice · doi:10.1155/2013/675634 · Cited by 12 · see citing works
Ekberg, J., Angbratt, M., Valter, L., Nordvall, M., & Timpka, T. (2012) · International Journal of Obesity · doi:10.1038/ijo.2011.263 · Cited by 10 · see citing works
Exploring Design Features and Benefits of Online Patient Education (OPE) Sites for Chronic Diseases
Hassan, N. M., Win, K. T., & Hyland, P. N. (2013) · Hawaii International Conference on System Sciences (HICSS) · doi:10.1109/hicss.2013.215 · Cited by 10 · see citing works
“(5 items) PTI1: Information tailored to patient’s symptoms [32, 42, 50]”
BackgroundImplementing Patient Accessible Health Information Site for Diabetes Management
Win, K. T. (2010) · Research Online (University of Wollongong) · Cited by 9 · see citing works
Liau, S. Y., Hassali, M. A., Shafie, A. A., & Ibrahim, M. M. (2011) · Health Expectations · doi:10.1111/j.1369-7625.2011.00742.x · Cited by 8 · see citing works
The Effects of an Internet Based Coaching Program for Obesity Management in Hypertensive Patients
Jeon, H. O., & Kim, O. (2011) · Korean Journal of Adult Nursing · Cited by 7 · see citing works
Vitale, E., Genovese, V. V., & Allenet, B. (2021) · Education thérapeutique du patient - Therapeutic patient education · doi:10.1051/tpe/2021007 · Cited by 6 · see citing works
Africa’s Telenursing Today (and Tomorrow?)
Wynchank, S., & Fortuin, J. (2011) · Cited by 4 · see citing works
Identifying design features of online patient education for chronic disease management
Hassan, N. M. (2013) · Research Online (University of Wollongong) · Cited by 2 · see citing works
Wynchank, S., & Fortuin, J. (2011) · Computers in health care · doi:10.1007/978-0-85729-529-3_11 · Cited by 1 · see citing works
African Telenursing: What is It and What's Special about It?
Wynchank, S., & Fortuin, J. (2010) · International Conference on eHealth, Telemedicine, and Social Medicine · doi:10.1109/etelemed.2010.10 · Cited by 1 · see citing works
“[19] This interactive principle is suitable for some African applications, for it is noted that vascular disease prevalence is steadily increasing in Africa, paralleling the continent’s rapid urbanisation of the last few decades.”
BackgroundEkberg, J. (2012) · DiVA (Linkoping University) · Cited by 1 · see citing works
Doolan‐Noble, F. (2010) · Otago University Research Archive (University of Otago) · Cited by 1 · see citing works
Online Health Information for Chronic Disease: Diabetes
Hassan, N. M., Win, K. T., & Hyland, P. N. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4514-2_19
고혈압 환자의 비만관리를 위한 인터넷 기반 코칭 프로그램의 효과
전해옥, & 김옥수 (2011)
Patterns of surveillance intensity in kidney cancer
Merrill, S. B., Loloi, J., Schaefer, É., & Hollenbeak, C. S. (2020) · International Urology and Nephrology · doi:10.1007/s11255-020-02685-7
Lin, M., Xie, S., Wang, B., & Siu, A. K. Y. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1932478
“Informal caregivers have also reported a poorer quality of life (QoL) compared to that of the general population (12).”
Nurse-led interpersonal counselling for depressive symptoms in patients with myocardial infarction
Oranta, O. (2011) · UTUPub (University of Turku)
- Authors
- Goessens, B. M. B., Visseren, F. L. J., de Nooijer, J., van den Borne, H. W., Algra, A., Wierdsma, J., & van der Graaf, Y.
- Affiliations
- University Medical Center Utrecht (NL)
- Venue
- Patient Education and Counseling
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 73
- Issue
- 1
- Pages
- 67-72
- ISSN
- 0738-3991 (ISSN-L)
- OpenAlex
- W2025040750
- Cited by
- 40
- References
- 36
- Citations by year
- 2026: 1 · 2023: 1 · 2021: 1 · 2020: 3 · 2017: 1 · 2016: 1 · 2015: 5 · 2014: 2 · 2013: 5 · 2012: 7
- FWCI
- 8.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Patient Education and Counseling (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Funders
- ZonMw
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Keywords
- vascular risk factors, nurse-led intervention, hypertension, hyperlipidemia, obesity, self-measured blood pressure, LDL cholesterol, blood glucose, arterial disease, e-health, feasibility, personalized action plan, nurse-patient communication
- MeSH terms
- Feasibility Studies, Female, Humans, Male, Middle Aged, Netherlands, Nurse Practitioners, Patient Education as Topic, Pilot Projects, Risk Factors, Vascular Diseases, Internet, Atherosclerosis, Telenursing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
