Healthy ageing through internet counselling in the elderly (HATICE): a multinational, randomised controlled trial

Edo Richard, MD; Eric P Moll van Charante, MD; Marieke P Hoevenaar-Blom, PhD; Nicola Coley, PhD; Mariagnese Barbera, PhD; Abraham van der Groep, MSc; Yannick Meiller, PhD; Francesca Mangialasche, PhD; Cathrien B Beishuizen, MD; Susan Jongstra, MD; Tessa van Middelaar, MD; Lennard L Van Wanrooij, MSc; Tiia Ngandu, MD; Juliette Guillemont, MSc; Sandrine Andrieu, ProfMD; Carol Brayne, ProfMD; Miia Kivipelto, ProfMD; Hilkka Soininen, ProfMD; Willem A Van Gool, ProfMD

The Lancet: Digital Health (Dec 2019)

Healthy ageing through internet counselling in the elderly (HATICE): a multinational, randomised controlled trial

Edo Richard, MD,
Eric P Moll van Charante, MD,
Marieke P Hoevenaar-Blom, PhD,
Nicola Coley, PhD,
Mariagnese Barbera, PhD,
Abraham van der Groep, MSc,
Yannick Meiller, PhD,
Francesca Mangialasche, PhD,
Cathrien B Beishuizen, MD,
Susan Jongstra, MD,
Tessa van Middelaar, MD,
Lennard L Van Wanrooij, MSc,
Tiia Ngandu, MD,
Juliette Guillemont, MSc,
Sandrine Andrieu, ProfMD,
Carol Brayne, ProfMD,
Miia Kivipelto, ProfMD,
Hilkka Soininen, ProfMD,
Willem A Van Gool, ProfMD

Affiliations

Edo Richard, MD: Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands; Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, Netherlands; Correspondence to: Dr Edo Richard, Department of Neurology, Amsterdam University Medical Center, University of Amsterdam 1105 AZ, Amsterdam, Netherlands
Eric P Moll van Charante, MD: Department of Primary Care, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Marieke P Hoevenaar-Blom, PhD: Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Nicola Coley, PhD: INSERM, University of Toulouse UMR1027, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
Mariagnese Barbera, PhD: Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
Abraham van der Groep, MSc: Vital Health Software, Ede, Netherlands
Yannick Meiller, PhD: Department of Information and Operations Management, ESCP Europe, Paris, France
Francesca Mangialasche, PhD: Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
Cathrien B Beishuizen, MD: Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Susan Jongstra, MD: Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Tessa van Middelaar, MD: Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Lennard L Van Wanrooij, MSc: Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
Tiia Ngandu, MD: Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
Juliette Guillemont, MSc: INSERM, University of Toulouse UMR1027, Toulouse, France
Sandrine Andrieu, ProfMD: INSERM, University of Toulouse UMR1027, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
Carol Brayne, ProfMD: Department of Public Health and Primary Care, Cambridge Institute of Public Health, University of Cambridge, UK
Miia Kivipelto, ProfMD: Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden; Neuroepidemiology and Aging Unit, School of Public Health, Imperial College London, UK
Hilkka Soininen, ProfMD: Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland; Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
Willem A Van Gool, ProfMD: Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands

Journal volume & issue: Vol. 1, no. 8
pp. e424 – e434

Abstract

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Summary: Background: Although web-based interventions have been promoted for cardiovascular risk management over the past decade, there is limited evidence for effectiveness of these interventions in people older than 65 years. The healthy ageing through internet counselling in the elderly (HATICE) trial aimed to determine whether a coach-supported internet intervention for self-management can reduce cardiovascular risk in community-dwelling older people. Methods: This prospective open-label, blinded endpoint clinical trial among people age 65 years or over at increased risk of cardiovascular disease randomly assigned participants in the Netherlands, Finland, and France to an interactive internet intervention stimulating coach-supported self-management or a control platform. Primary outcome was the difference from baseline to 18 months on a standardised composite score (Z score) of systolic blood pressure, LDL cholesterol, and body-mass index (BMI). Secondary outcomes included individual risk factors and cardiovascular endpoints. This trial is registered with the ISRCTN registry, 48151589, and is closed to accrual. Findings: Among 2724 participants, complete primary outcome data were available for 2398 (88%). After 18 months, the primary outcome improved in the intervention group versus the control group (0·09 vs 0·04, respectively; mean difference −0·05, 95% CI −0·08 to −0·01; p=0·008). For individual components of the primary outcome, mean differences (intervention vs control) were systolic blood pressure −1·79 mm Hg versus −0·67 mm Hg (−1·12, −2·51 to 0·27); BMI −0·23 kg/m2 versus −0·08 kg/m2 (−0·15, −0·28 to −0·01); and LDL −0·12 mmol/L versus −0·07 mmol/L (−0·05, −0·11 to 0·01). Cardiovascular disease occurred in 30 (2·2%) of 1382 patients in the intervention versus 32 (2·4%) of 1333 patients in the control group (hazard ratio 0·86, 95% CI 0·52 to 1·43). Interpretation: Coach-supported self-management of cardiovascular risk factors using an interactive internet intervention is feasible in an older population, and leads to a modest improvement of cardiovascular risk profile. When implemented on a large scale this could potentially reduce the burden of cardiovascular disease. Funding: European Commission Seventh Framework Programme.

Published in The Lancet: Digital Health

ISSN: 2589-7500 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Medicine (General): Computer applications to medicine. Medical informatics
Website: https://www.thelancet.com/journals/landig/home

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