A virtual community of practice to improve the empowerment of people with ischaemic heart disease: a randomized controlled trial

Débora Koatz, Helena Vall-Roque, Patricia Cifuentes, Vanesa Ramos, Alexandra Torres, Anthea Santos, Ana Toledo, Javier García, Valeria Pacheco, Lilisbeth Perestelo-Pérez, Carola Orrego, Ana Isabel Gonzalez-Gonzalez

Keywords: Ischemic heart disease, virtual community of practice, self-management, empowerment, randomized controlled trial

Background:

Virtual Communities of Practice (VCoP) offer ubiquitous access to knowledge for people in similar situations. Main benefits include information exchange, social support, and skills improvement to cope with the disease. There is scarce evidence on the clinical impact of these interventions on people with chronic conditions.

Research questions:

What is the effectiveness of a VCoP regarding patient activation and other patient relevant measures in people with recent diagnosis of ischaemic heart disease (IHD)?

Method:

A pragmatic randomised controlled trial is taking place in Catalonia, Madrid and Canary Islands, Spain. Three hundred patients with a recent diagnosis of IHD must be recruited to participate in the intervention/control (usual care) group. The intervention group is offered participation in a co-designed gamified VCoP for 12 months, which proposes tailored content based on empowerment dimensions developed by a multidisciplinary team. The primary outcome is the Patient Activation Measure. Secondary outcomes include clinical variables, knowledge, attitudes, adherence to Mediterranean diet, physical activity, depression, anxiety, medication adherence, quality of life and health resources use. Data is collected from self-reported questionnaires at baseline, 6, 12 and 18 months.

Results:

Two-hundred eighty-two participants have been included since June 2021. Preliminary results show that, at 12 months, a significant difference is found for patient activation and adherence to Mediterranean diet: the change in the trajectory of the two groups over time is significant, favouring the intervention group. A tendency towards significance is also found for self-efficacy on managing the disease.

Conclusions:

Due to COVID-19, recruitment is a major challenge. Although the study is still in progress, preliminary results suggest that using a VCoP might be a useful approach for individuals with IHD to improve their empowerment.
This study has been funded by Instituto de Salud Carlos III through projects “PI18/01404, PI18/01397, PI18/01333”, co-funded by European Regional Development Fund (ERDF), “A way of shaping Europe”.

Points for discussion:

How to optimize patient recruitment with the post COVID-19 situation

Usefulness of VCoP for IHD and other chronic diseases: strengths and limitations

How to overcome the barriers and limitations that VCoP might pose for people with chronic diseases