Improving Adherence in a Coronary Disease Reversal Program with Web-Based Technology

Heart disease is the leading cause of death in the United States and the economic cost of health care to those with coronary heart disease is staggering. Studies of cardiac disease prevention have proven the value of such interventions. The Coronary Artery Disease Reversal Program (CADRe) at Walter Reed Army Medical Center hopes to validate the value of such a program for military medical beneficiaries. Adherence to programs requiring comprehensive lifestyle changes is very difficult despite the structured model of program support and participation. Case management by the clinical team through timely identification of risk behaviors, appropriate interventions based on these behaviors, and evaluation of patient goals is key to participant adherence and ultimate success. The use of an internet-based two-way interactive communication link between participant and clinical team may provide a more rapid means of accessing self-reported patient data and assessing potential behaviors that would benefit by clinical team support. The overall purpose of this study is to conduct a randomized comparative study to measure the efficacy of the use of an Internet-based interactive communication link in the overall adherence to a coronary artery disease reversal program using an outcomes framework. It may also provide significant information on, not only its efficacy, but, also on the impact use of this web-based technology on reduction of the participant's associated cardiac risk factors. Adherence will be measured as a percent of minimum recommended level of adherence of program components. Functional status will be measured using the SF 36 (Short Form Health Status). A Participant Evaluation of Health Buddy« Appliance will measure participant satisfaction with the technology. The proposed research could reduce participant's cardiac risk factors, improve functional status, but also change the way case management is practiced in future prevention and wellness programs.