Unhealthy lifestyles and low adherence to blood pressure and cholesterol treatments are the main reasons why cardiovascular patients suffer recurrent episodes.

We have also recently shown that insomnia and psychological stress are frequently occurring among cardiovascular patients and are associated with poor prognosis and decreased quality of life. Despite strong recommendations, less than 15% receive cardiac rehabilitation, mainly due to a lack of hospital-based programs. In response to these challanges, our research and innovation project aims to test effectiveness of an individualized digital collaborative intervention. This intervention is designed to enhance and integrate existing services offered by general practitioners, health and wellness centers, and the National Association in addressing the primary causes of cardiovascular disease. Our ultimate focus is on improving patient outcomes and quality of life.

A pragmatic, randomized, open-label, parallel-group, blinded endpoint evaluation (PROBE) intervention multicenter study will include 600 patients hospitalized with coronary artery disease, ischemic stroke, or peripheral vascular disease. Patients with access to a smartphone or tablet, residing in 6-10 Vestre Viken municipalities, and with a life expectancy of greater than 12 months will be randomly assigned to either the intervention group or the control group following their current standard clinical practice with written information.

The intervention group will receive access to and guidance on using a digital platform for 12 months with automatic reminders where: i. individualized goals and action plans are developed in the hospital to address risk factors and psychosocial issues using motivational interviewing techniques, ii. appointments will be scheduled for follow-up of the action plan with their general practitioner and at the health and wellness center. Study data will be collected from the digital platform, medical records, national registries, questionnaires, watches, and clinical examinations. A health economic cost-benefit analysis will be conducted, calculating quality-adjusted life years to evaluate the effectiveness of the intervention.

The study will contribute to enhanced follow-up care of cardiovascular patients by working closely with the voluntary sector. This collaboration will lead to a more individualized approach that can effectively target and reduce risk factors, ultimately enhancing the quality of life for these patients. Improved patients risk profiles and reducing psychological stress can lead to significant health and socio-economic benefits. Furthermore, enhanced collaboration among various levels of care is expected to alleviate strains on both primary and specialist health services while reinforcing the National Association of Public Health’s influence by fostering the development of transferable knowledge applicable to a range of non-communicable diseases.

The project is led by John Munkhaugen in collaboration with research coordinator Anja Lia. The pilot study is set to commence in the spring of 2024, followed by the main study in 2025. The first PhD candidate will join the team in the spring of 2025.