Blended collaborative care in the secondary prevention of coronary heart disease improves risk factor control: Results of a randomised feasibility study
Background: Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary
active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g.
distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care
manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care
across providers, targeting both, somatic and psychosocial risk factors.
Aims: The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care
intervention in Germany.
Methods: For our randomised controlled pilot study with a crossover design we recruited coronary heart disease
patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended
collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20).
Results: Participation rate in the intervention phase was 67% (n=40), and participants reported high satisfaction
(M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly
from baseline to six months in the immediate intervention group (t(60)=3.07, p=0.003), but not in the waiting control
group t(60)=–0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting
control group also showed a significant reduction of risk factors (t(60)=3.88, p<0.001).
Conclusion: This study shows that blended collaborative care can be a feasible, accepted and effective addition to
standard medical care in the secondary prevention of coronary heart disease in the German healthcare system
