Telephone Health Coaching and Remote Exercise Monitoring (TeGeCoach) in Peripheral Arterial Occlusive Disease—a Randomized Controlled Trial.

IF 6.5 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Deutsches Arzteblatt international Pub Date : 2024-05-17 DOI:10.3238/arztebl.m2024.0008
Farhad Rezvani, Dirk Heider, Hans-Helmut König, Lutz Herbarth, Patrick Steinisch, Franziska Schuhmann, Hannes Böbinger, Gundula Krack, Thomas Korth, Lara Thomsen, Daniela Patricia Chase, Robert Schreiber, Mark-Dominik Alscher, Benjamin Finger, Martin Härter, Jörg Dirmaier
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Abstract

Background: Supervised exercise programs are used to treat intermittent claudication (IC). Home-based exercise programs have been developed to lower barriers to participation. We studied the effects of one such exercise program (TeGeCoach) on self-reported walking ability in patients with IC.

Methods: In a pragmatic multicenter randomized controlled trial (registration number NCT03496948), 1982 patients with symp - tomatic IC insured by one of three German statutory health insurance funds received either telephone health coaching with remote exercise monitoring (TeGeCoach; n = 994) or routine care (n = 988). The primary outcome was the change in Walking Impairment Questionnaire (WIQ) scores after 12 and 24 months in the intention-to-treat population. The secondary outcomes were healthrelated quality of life, symptoms of depression or anxiety, health competence, patient activation, alcohol use, and nicotine depen - dence.

Results: There was a significant group difference in WIQ score in favor of TeGeCoach (p < 0.0001), amounting to 6.30 points at 12 months (Bonferroni-corrected 95% CI [4.02; 8.59], Cohen's d = 0.26) and 4.55 points at 24 months ([2.20; 6.91], d = 0.19). Some of the secondary outcomes also showed positive results in favor of TeGeCoach at 12 months with small effect sizes (d ≥ 0.20), including physical health-related quality of life and patient activation. The average daily step count was not higher in the TeGeCoach group.

Conclusion: Significant improvements regarding symptom burden demonstrate the benefit of a home-based exercise program and thus expand the opportunities for guideline-oriented treatment of IC. Future studies should additionally address the effect of home-based exercise programs on clinical variables by means of, for example, the 6-minute walk test.

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电话健康指导和远程运动监测(TeGeCoach)在外周动脉闭塞性疾病中的应用--随机对照试验。
背景:有指导的锻炼计划通常用于治疗间歇性跛行(IC)。为了降低参与障碍,人们开发了基于家庭的锻炼计划。我们研究了一个此类项目(TeGeCoach)对间歇性跛行患者自述步行能力的影响:在一项务实的多中心随机对照试验(注册号为 NCT03496948)中,1982 名有症状的 IC 患者在德国三家法定医疗保险公司中的一家投保,接受了带有远程运动监测功能的电话健康指导(TeGeCoach;n = 994)或常规护理(n = 988)。主要结果是干预开始后12个月和24个月步行障碍问卷(WIQ)得分的变化(意向治疗分析)。次要结果是与健康相关的生活质量、抑郁或焦虑症状、健康能力、患者积极性、酒精使用和尼古丁依赖:结果:在 WIQ 方面,治疗组与治疗组之间存在明显差异,TeGeCoach 更胜一筹(P 0.20)。TeGeCoach组的每日平均步数没有增加:结论:观察到的症状负担减轻情况表明,家庭锻炼计划在治疗间歇性跛行方面具有优势。此类计划为以指南为导向的间歇性跛行治疗提供了更多机会。未来的研究应探讨家庭锻炼计划对临床变量(如 6 分钟步行测试)的影响。
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来源期刊
Deutsches Arzteblatt international
Deutsches Arzteblatt international 医学-医学:内科
CiteScore
4.10
自引率
5.20%
发文量
306
审稿时长
4-8 weeks
期刊介绍: Deutsches Ärzteblatt International is a bilingual (German and English) weekly online journal that focuses on clinical medicine and public health. It serves as the official publication for both the German Medical Association and the National Association of Statutory Health Insurance Physicians. The journal is dedicated to publishing independent, peer-reviewed articles that cover a wide range of clinical medicine disciplines. It also features editorials and a dedicated section for scientific discussion, known as correspondence. The journal aims to provide valuable medical information to its international readership and offers insights into the German medical landscape. Since its launch in January 2008, Deutsches Ärzteblatt International has been recognized and included in several prestigious databases, which helps to ensure its content is accessible and credible to the global medical community. These databases include: Carelit CINAHL (Cumulative Index to Nursing and Allied Health Literature) Compendex DOAJ (Directory of Open Access Journals) EMBASE (Excerpta Medica database) EMNursing GEOBASE (Geoscience & Environmental Data) HINARI (Health InterNetwork Access to Research Initiative) Index Copernicus Medline (MEDLARS Online) Medpilot PsycINFO (Psychological Information Database) Science Citation Index Expanded Scopus By being indexed in these databases, Deutsches Ärzteblatt International's articles are made available to researchers, clinicians, and healthcare professionals worldwide, contributing to the global exchange of medical knowledge and research.
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