Six-month programme on lifestyle changes in primary cardiovascular prevention: a telemedicine pilot study

Background: Technology and information systems enabling transmission of patients' data and ability to provide and exchange professional support remotely to the general practitioners can improve quality and continuity of care. Design: We set up a programme of primary prevention in 27 patients at risk for cardiovascular diseases by using Telemedicine Service for 6 months. Methods: Telemedicine Service enlisted the involvement of physicians and nurse-tutors. The following cardiovascular activity markers were assessed: (i) cardiovascular risk cards (Framingham Study and Progetto CUORE); (ii) blood pressure; (iii) physical activity (three sessions of bicycle exercise training and calisthenic exercises a week); and (iv) questionnaires on stress and quality of life. Results: Both cardiovascular risk cards showed a statistically significant reduction of the score (p<0.05). Systolic and diastolic blood pressures showed a statistically significant reduction (128 +/- 10 mmHg vs. 121 +/- 9 mmHg, p = 0.04; 80 +/- 8 mmHg vs. 73 +/- 7 mmHg, p = 0.001). There was a noticeable increase in patient compliance for reporting blood pressure data. 89% of patients complied with the physical activity programme. Effort test significantly increased from 11.4 +/- 3.5 to 12.7 +/- 3.4 min (p = 0.02). There was a significant improvement in physical health (p 0.04) and 85% of patients were satisfied with the service. Conclusions: A home multidisciplinary programme for primary cardiovascular disease prevention is simple, efficacious, and very well accepted by the patients with the majority of patients showing reduction in cardiovascular risk scores.