Online heart disease education program helps patients

May 16 2007

Patients who used the American Heart Association's online heart disease education program were more aware of treatment options than other patients, researchers reported at the American Heart Association's 8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.

Those who used Heart ProfilersTM , the American Heart Association's Internet-based education program developed with Thomson Healthcare , also were more likely to ask their doctors about their care, according to survey results. Researchers examined the association between use of the Heart Profilers program and patient knowledge and behavior. Patients with coronary artery disease (CAD), atrial fibrillation (AF), heart failure (HF), high cholesterol or hypertension who registered to use Heart Profilers were invited to answer an Internet questionnaire. Their responses were compared with a randomly selected control group who had not used the Heart Profilers.

"Patients who used the Heart Profilers, particularly those with HF and AF, reported a greater understanding of their heart medications than other heart patients who used other Internet sources," said Ileana Pi'a, M.D., professor of medicine at Case Western Reserve University and senior author on the study.

"Patient education and empowerment are key pathways in reducing complications of cardiovascular disease," she said.

"The Heart Profilers tool empowers patients to take control and manage their condition by providing personalized information in lay language so patients have a complete picture of their condition and treatments relevant to their diagnosis profile."

Chronic disease is an ever-growing problem among patients with heart disease. Patient education is critical for improving compliance and for patients to partner with their health care providers in managing their own cardiovascular issues. The Heart Profilers provide accurate information in lay language in the safe setting of the home.

Upon registration with Heart Profilers, patients are asked to complete a questionnaire to receive a free, confidential, personalized treatment options report. Users receive information, based on peer-reviewed, scientifically based literature, regarding success rates of various treatment options, potential medication side effects and questions to ask their healthcare providers. Patients also have access to medical journal abstracts and research studies written in an easy-to-understand format.

"Again, this format takes the patient to accurate and up-to-date information," Pi'a said. "Other Internet sites may be replete with misinformation. It may be difficult for the average patient to separate accurate education from false information. The trust in the American Heart Association allows them to be confident in what education they receive and access for themselves."

Researchers divided respondents into three groups: those who completed the Heart Profiler questionnaire (users), those who registered but did not complete it (registrants) and a control sample of non-users with one of the five heart conditions, who were identified via a nationally representative telephone survey, (controls). There were 1,039 users, 389 registrants and 1,564 controls.

Users and registrants were younger (average age 53.9 and 55.9 years) versus controls (average age 64.4). Nearly half of users and registrants held a four-year college degree, compared to one-third of controls. Users took 2.8 heart medications, registrants took 3.0 and controls 2.3. However, they had a similar number of heart conditions.

Consistent with their greater understanding of medications, HF and AF patients reported a greater tendency to use their medications as prescribed by their doctor, researchers said.

"It's beneficial for patients to be educated in this way," Pi'a said. "When patients understand the different treatment options available to them, they can become more active participants in their healthcare decision-making by asking appropriate questions and understanding what their doctor is telling them.

"In essence, when there is a two-way dialogue between patient and doctor (referred to as 'shared decision-making'), there is a greater chance that patients believe treatment decisions made with the doctor are the best for them personally. When patients believe the treatment is the right one, they will be more likely to stick with it," she added.

"This is the same logic for having better knowledge about medications , if you believe in the necessity and importance of the medication, you will be more likely to take it as prescribed," Pi'a said.

According to researchers, users were 1.58 times more likely than controls to be aware of four or more AF treatments. And they were 1.56 times more likely to ask their doctors about medications or treatments that they had heard about outside the doctor's office.

Heart Profilers seemed to benefit patients with HF and AF more than others, possibly because "HF and AF are more chronic conditions, so they have a greater impact on overall health and functioning and patients may be more symptomatic," Pi'a said. "Patients literally feel these conditions more, whereas you don't feel high cholesterol. Therefore, when patients with HF and AF access the Heart Profilers, they may be ready to make more active use of the information provided than other patients. Physicians are increasingly expected to provide education for patients with chronic cardiovascular diseases. Heart Profilers can serve as a powerful adjunct for physicians to recommend to their patients, as well."

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