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Table 4 Characteristics of e–Health interventions (N = 24) based on the Template for Intervention Description and replication (TIDieR) checklist22

From: Modes of e-Health delivery in secondary prevention programmes for patients with coronary artery disease: a systematic review

Reference

Mode of delivery

Materials

Secondary prevention core components

Theoretical framework

Health professionals

Setting

Duration

Intensity

Effect on outcome i, ii and/or iii

m-health

Thakkar et al. 2016. Chow et al. 2016 [27, 28]

m-Health.

4 modules with text messages offered information on major secondary prevention areas; physical activity, diet, smoking cessation, general cardiac education.

MM, HE

Behavioural change technique.

 

e-Health and traditional exercise based CR.

6 months.

96 messages, 1 text message 4 days a week, on random weekdays.

ii

Johnston et al. 2016 [30]

m-Health.

Four main modules: Extended drug adherence e-diary to register daily ticagrelor intake, exercise, weight and smoking. Feedback and information messages General information regarding the cause, symptoms, and treatment of MI.

MM, HE

  

e-Health and standard secondary prevention care.

6 months.

 

i

Fang et al. 2016 [32]

m-Health.

Text messages reminders for medications. Micro letter platform which CAD-related education materials (text, images and media content).

MM, HE

 

A nurse and a physician.

e-Health

6 months.

Educational materials and reminders via the Micro letter platform at regular intervals.

i

Park et al. 2015. Park et al. 2014 [37, 38]

m-Health.

Text messages reminders for medications, text messages education.

MM, HE

Self-efficacy theory.

Nurse.

e-Health

1 month.

Daily text messages reminders, text messages education 3d/week.

i

Khonsari et al.2015 [39]

m-Health.

Text messages reminders for medications, 30-day medication dosage and reminder to come to the hospital and have their prescribed cardiac medication refilled.

MM

  

e-Health

2 months.

Daily text messages reminders.

i, ii

Blasco et al. 2012 [44]

m-Health.

Biological and clinical data accessed via telemonitoring, individualized short text messages with recommendations including lifestyle counseling.

SM, MM

 

Cardiologist.

e-Health and and three clinical visits.

12 months.

Patients sent, through mobile phones, biological and clinical data weekly, and subsequently received individualized text messages with recommendations.

ii

Web-based technology

Norlund et al. 2018 [26]

Web-based technology.

10 treatment modules with 2–4 treatment steps each, homework assignment, feedback, discussion boards, a library with supplementary material and video clips, and text-based psychoeducation. Self-monitoring of mood and daily activities.

HE, PM, SM

Internet-based cognitive behavioral therapy (iCBT).

Psychologist.

e-Health

3.5 months

Patients were recommended to work with one step per week.

 

Vieira et al. 2018. Vieira et al. 2017 [47, 48]

Web-based technology.

An exercise protocol, and diary, heart rate monitor, virtual reality exercise programme composed of 3 modules.

PA

  

e-Health

6 months.

The exercise protocol was performed three times a week over 6 months.

ii

Lear et al. 2015 [36]

Web-based technology.

Heart rate monitor and a blood pressure monitor, on-line intake medical, risk factor and lifestyle forms, scheduled one-to-one chat sessions, education sessions (interactive slide presentations), data capture for the exercise test and blood test results, progress notes, and monthly ask-an-expert group chat sessions.

SM, PA, HE

 

Programme nurse case manager, exercise specialist and dietitian.

e-Health

3 months.

Chat session three times during 12 weeks, weekly education sessions, monthly ask-an-expert group chat sessions, upload their exercise data at least twice per week.

ii

Devi et al. 2014 [41]

Web- based technology.

A online exercise diary recording details of daily exercise, self-monitoring, education on behaviour change techniques, feedback on behaviour goals, information about health consequences, and reducing negative emotions.

HE, SM, PM

Behaviour change techniques.

Cardiac nurses.

e-Health.

1.5 months.

The participants were told to log in daily to record their daily physical activity.

ii, iii

Vernooij et al. 2012 [43]

Web- based technology.

Web page containing risk factor measurements, drug use, treatment goal and advice from the nurse, correspondence between nurse and patient, news items for that particular risk factor. Patients were able to submit new measurements, to read and send messages.

MM, SM, HE

Chronic care model.

Nurse.

e-Health and usual care.

12 months.

The treating nurse practitioner logged in every working day and replied to messages sent by patients and sent messages to patients not using the programme at least every other week.

 

Reid et al. 2011 [45]

Web- based technology.

Five tutorials designed to foster behavioral capability, self-efficacy, social support, and realistic outcome expectations. Following each tutorial a new physical activity plan was developed. Between tutorials, participants received emails from the exercise specialist providing motivational feedback.

HE, PM, PA

 

Exercise specialist.

e-Health.

6 months.

Five online tutorials (at weeks 2, 4, 8, 14, and 20). Each online tutorial took between 10 and 20 min to complete. Asked to log daily activity.

ii, iii

Lindsay et al. 2009 [46]

Web- based technology.

Discussion groups, one-to-one instant messaging with moderators, glossary and information about CAD, diet, exercise and smoking, links and references to local community resources where they could seek help and advice.

PM, HE

 

Moderator.

e-Health

9 months.

The first 6 months the project were moderated, while the remaining 3 months were unmoderated.

ii

Southard et al. 2003 [49]

Web- based technology.

Web-based program to provide risk factor management support, education, and monitoring services to patients with CVD. Online assessments, online discussion group, a list of participants’ e-mail addresses, and links to related sites on the Internet.

SM, HE

 

Nurse case managers.

e-Health.

6 months.

Logging on to the site at least once a week for 30 min, communicating with a case manager and dietitian, completing education modules, and entering data into progress graphs.

 

Combination

Widmer et al. 2017 [29]

Combination of m-Health and web-based technology.

Access to health status information, reporting of dietary and exercise habits, graphics showing trends, a social reinforcement networks, educational modules with tasks, targets and plans.

SM, HE, PM

Patient-centered and evidence based material.

Study coordinator.

e-Health and standard phase II CR.

3 months.

Daily tasks, patients were asked to complete educational tasks on a regular basis.

ii

Wolf et al. 2016 [31]

Combination of m-Health and web-based technology.

The mobile app consisted of 3 modules: Self-rated fatigue, symptom trend graph, and built in accelerometer. The web page consisted of 5 modules: Self-rated fatigue, symptom trend graph, diary to capture the everyday experience. Chat function with other patients and nurses, personal links to relevant webpages.

SM, PM

PCC approach.

Nurses and a physician.

e-Health and PCC intervention face-to-face.

At least 2 months.

The patients decided on the frequency and patterns of use of the tool.

iii

Pfaeffli Dale et al. 2015 [33]

Combination of m-Health and web-based technology.

Self-monitoring of physical activity, access to supporting web-page, daily text messages, text an expert to request personalized feedback, health information and recommendation about lifestyle changes via a participant blog, graphs displaying their pedometer step-count, and short video messages from role models and medical professionals.

SM, PM, HE

Social cognitive theory.

 

e-Health and standard CR.

6 months.

Daily text messages for 13 weeks. From week 13 to 24 the frequency of messages decreased to 5 per week. Self-monitoring of physical activity with pedometer.

i

Maddison et al. 2015 [34]

Combination of m-Health and web-based technology.

Personalized automated package of text messages aimed to increase exercise behaviour, additional information was provided via a web-page including role model video vignettes, an opportunity to self-monitoring progress, and information on various forms of physical activity advice, and links to other website.

PM, SM, HE

The m-Health development and evaluation framework.

 

e-Health and community-based cardiac rehabilitation.

6 months.

Six text messages per week for the first 12 weeks, five text messages per week for 6 weeks and then four text messages per week for remaining 6 weeks; total 118 messages.

ii, iii

Frederix et al. 2015 [35]

Combination of m-Health and web-based technology.

A patient-specific exercise training protocol, accelerometer for self-monitoring, dietary recommendations, smoking cessation and physical activity tele-coaching strategies, personalized automated feedback emails and text messages encouraging the patients to achieve recommendations.

PA, HE, SM

 

A health professional who had coached cardiac patients for more than 5 years, supervised by cardiologist.

e-Health and conventional cardiac rehabilitation.

6 months.

Feedback on email and text messages once weekly.

ii, iii

Frederix et al. 2015 [40]

Combination of m-Health and web-based technology.

An accelerometer which registered activity data, personalized automated feedback, emails and text messages designed to encourage the patient to increase daily activity.

PA, HE, SM

  

e-Health and cardiac rehabilitation phase II.

4.5 months.

Weekly upload of physical activity data. Weekly personalized feedback on physical activity by email or text message.

ii

Varnfield et al. 2014 [42]

Combination of m-Health and web-based technology.

“My heart, My life” manual, health and exercise monitoring, preinstalled audio and video files, motivational and educational materials delivered via text messages.

SM, HE

  

e-Health

1.5 months.

Weekly scheduled telephone consultations (15 min each), weekly consultations via the web portal to provide informed, personalised feedback on progress according to goals set.

i, iii

  1. Abbreviations: CAD Coronary artery disease, CR Cardiac rehabilitation, HE Health education, MI Myocardial infarction, MM Medical risk management, PA/EM Physical activity and exercise management, PCC Person centred care, PM psychological management, SM Self-monitoring
  2. Outcome: i: Adherence to treatment; ii: Modifiable CAD risk factor; iii: Psychosocial outcomes