Effectiveness and cost-effectiveness of a virtual Community of Practice in the empowerment of patients with ischemic heart disease: An ongoing randomized controlled trial.

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

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

Virtual Communities of Practice (VCoP) offer access to information and exchange possibilities for people in similar situations, which might be especially valuable for the self-management of chronic diseases.

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

A pragmatic randomized controlled trial is being performed in Catalonia/Madrid/Canary Islands, Spain. Three-hundred patients with a recent diagnosis of IHD attending participating centres (GP practices/hospitals) are selected/randomized to the intervention/control group to reach the sample size. Intervention group is offered participation for 12 months in a VCoP based on a gamified web 2.0 platform with educational material, plus interaction with other patients and a multidisciplinary professional team. Intervention/control groups are receiving usual care. Primary outcome is measured with Patient Activation Measure (PAM) questionnaire (baseline/six/12/18 months). Secondary outcomes include: clinical variables; adherence to Mediterranean diet (PREDIMED); physical activity (IPAQ), depression (PHQ-9), anxiety (HADS-A); medication adherence (ARMS); quality of life (EQ-5D-5L); health resources use. Data is collected from self-reported questionnaires/electronic medical records.

One hundred and eighty-one participants (16.5% women, mean age: 58.3, SD: 8.89, age range: 39-81) have been included from June 2021 (60% of the sample size needed), 99 in the intervention and 82 in the control group. Sixty-six participants fulfilled the six-month questionnaires out of 117 that have already been involved in the trial for six months. Results at six-month follow-up will be available at the congress.

Due to COVID-19 situation recruitment is a major challenge. Participants will be recruited continuously until sample size is achieved to maintain trial integrity/validity. The results of this study will provide evidence on the effectiveness/cost-effectiveness of an alternative way of managing patients with recent diagnosis of IHD by using a VCoP, which could be extended to other chronic patients/settings.

Points for discussion:
How to optimize patient recruitment with the 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