Comparing the Success of ECare Interventions for Chronic Disease Management and Disease Prevention

Abstract

Background With aging population there is an increasing occurrence in a number of chronic diseases. Diabetes and asthma, in particular, have reached threatening dimensions worldwide. In Slovenia, 120,911 people live with diabetes. Worldwide, the estimated number in 2012 was nearly 366 million and it is expected to increase to 552 million by 2030. Similarly, more the 100,000 people in Slovenia and 235 million people worldwide suffer from asthma. Consequently, chronic diseases impose a large economic burden on healthcare systems. We have developed an eCare web-portal for self-management and behavior change for chronic diseases and disease prevention. Objectives To clinically evaluate the success of the eCare system through randomized control trials (RCT) for self-management of asthma and diabetes type II as well as clinical trials of preventive interventions, eWeight-loss and eSport. To compare the success of the interventions and to find out why not all interventions are equally successful. To discover how demographic, psychological or clinical factors influence success. Methods In the first phase of the project, the core eCare system was developed. Clinical partners we involved in the development of intervention definitions and in the clinical trial design. The second phase, the clinical trial, consisted of a number of activities: participant education; control over the care intervention and collected data and regular meetings with the medical professionals. To achieve the objectives, special attention was given to the evaluation questionnaire development. The questionnaire consisted of five components with questions for: collecting user demographic data, evaluation the eCare application, collecting user expectations, satisfaction and suggestions for improvements as well as a set of intervention related question about the condition management. In the third phase, data analysis will be used to assess the effectiveness of a particular intervention and the success of the eCare system. Results The eCare applications for supporting self-management of two chronic diseases and two preventive intervention were implemented and deployed. All clinical trials were approved by the Ethics Committee. In the RCT of eAsthma, the number of patients was smaller then planned. The RCT for Diabetes type II, eDiabetes, is a multi-center trial including 17 family medicine clinics. The expected number of patients was reached during the recruitment period. The clinical trial for weight loss and eSport have more participants then planned. Conclusion The eCare system was successfully used for several interventions. The system is patient centered and includes tools for self-care support, health education and communication. It also provides supporting tools for medical professionals. Collected data from the clinical trials will enable the evaluation of each eCare application. Since the eCare system was used to support conditions with different care protocols, the data collected will enable comparison of the success of the interventions and to discover why some interventions work well and others do not. It will also help determine whether some clinical problems or behaviors are more responsive to change by computer-based interventions.