Healthy aging through internet counseling in the elderly

ISRCTN ISRCTN48151589
DOI https://doi.org/10.1186/ISRCTN48151589
Secondary identifying numbers 305374
Submission date
18/06/2014
Registration date
05/09/2014
Last edited
07/04/2022
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Background and study aims
Older people that have cardiovascular disease (for example, heart disease, stroke) or have a number of risk factors that make them more likely to develop cardiovascular disease (for example, high blood pressure, diabetes, high cholesterol levels) are at an increased risk of a heart attack (myocardial infarction), stroke, dementia and death. Effective treatment for cardiovascular disease is available, but may not be enough to prevent serious health problems in cases where the patient has a number of risk factors. Being able to manage these risk factors is therefore thought to have an important preventive role and getting the patients actively involved is also likely to be beneficial. HATICE is an internet programme (intervention) that has been developed to help older people to manage their own health and, in particular, manage their pre-existing cardiovascular risk factors. Here, we want to find out if such an intervention can help prevent cardiovascular disease and also prevent, or at least delay, the onset of dementia.

Who can participate?
Adults that are at least 65 years of age, have two or more cardiovascular risk factors or have a history of cardiovascular disease.

What does the study involve?
Participants are randomly allocated into one of two groups. Those in group 1 are able to use an interactive internet programme that helps and encourages them to make changes to their lifestyle and manage their own risk factors. Those in group 2 are given their usual care and also access to an internet programme similar in appearance to that used by group 1 participants, but only providing general information on a healthy lifestyle, without the interactive features. Each participants BMI, blood pressure and blood cholesterol levels are taken before the start of the trial and 18 months later. They are also asked to fill out questionnaires on disability, depression, physical activity, diet, quality of life and self-management. They are also tested for dementia.

What are the possible benefits and risks of participating?
All participants have a blood sample taken at before the start of the trial and 18 months later.
Participants in group 1 may benefit from the interactive internet programme and find that their risk of cardiovascular disease is reduced.

Where is the study run from?
The HATICE study has been set up by the Academic Medical Centre (AMC) in Amsterdam, the University of Eastern Finland (UEF), Institut National de la Sante et de la Recherche Medicinale (INSERM) in France, the Karolinska Institutet in Sweden and the University of Cambridge in England. Recruitment of participants will take place in three countries (Netherlands, Finland, France).

When is study starting and how long is it expected to run for?
January 2015 to January 2018

Who is funding the study?
European Unions' Seventh Framework Programme

Who is the main contact?
Dr E. Richard
E.richard@amc.nl

Study website

Contact information

Dr Edo Richard
Scientific

Academic Medical Centre Amsterdam
Meibergdreef 9
Amsterdam
1105 AZ
Netherlands

Study information

Study designEuropean multi-centre investigator-initiated open-label blinded endpoint (PROBE) parallel-group randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Internet/virtual
Study typePrevention
Participant information sheet Currently not available in web format, please use the contact details below to request a patient information sheet. For each country we will have a website where patient information will be available. These are currently under construction. Dutch website: www.capio-onderzoek.nl Finnish website: www.terveika.fi French website: www.resteractif.fr
Scientific titleHealthy aging through internet counseling in the elderly: a European, multi-centre, investigator initiated, open-label blinded endpoint (PROBE), parallel group, randomised controlled trial
Study acronymHATICE
Study objectivesTo investigate whether an interactive internet-based intervention strategy targeting vascular and lifestyle-related risk factors can lead to improvement of cardiovascular risk profile and prevention of cardiovascular disease and whether this in turn may prevent or delay the onset of cognitive decline and dementia.
Ethics approval(s)1. Northern Savonia Hospital District Research Ethics Committee (Finland), 10/06/2014, ref: 35/2014
2. Medical committee of the Academic Medical Center (Netherlands), 26/06/2014, ref: METC 2014_126.
3. Comité de Protection des Personnes (CPP) Sud Ouest et Outre Mer (France), 24/09/2014, ref: 2014-A01287-40
Health condition(s) or problem(s) studiedCardiovascular prevention
Intervention1. The intervention group is provided with access to an interactive internet platform supported by a coach to facilitate and encourage self-management of risk factors and lifestyle change.
2. The control group receives care as usual and access to an internet platform similar in appearance, but only providing general information on a healthy lifestyle, without the interactive features.
Intervention typeOther
Primary outcome measureThe primary endpoint of the study is a weighted composite score based on z-scores of the difference between baseline and 18 months follow-up values of systolic blood pressure, cholesterol and BMI. The rationale behind this primary outcome is that:
1. 18-months follow-up is too short for a significant number of clinical outcome events even when using this sample size
2. Only measurable risk factors are included (self-reported factors such as physical exercise are sensitive to bias)
3. This will allow for very sensitive and direct assessment of the risk factors we target
This has the potential caveat of making a type I error, but even a very small effect on cardiovascular risk profile could have considerable effect at the population level (prevention paradox).
Secondary outcome measuresMain secondary outcomes are:
1. Z-scores of individual components of the primary outcome only in persons who have this risk score at baseline
2. Improvement in estimated 10-year cardiovascular disease risk based on the Framingham cardiovascular disease risk score (measured at 18 months)
3. Incident cardiovascular disease (stroke/TIA, myocardial infarction, peripheral arterial disease, heart failure)
4. Improvement of the number of measurable risk factors (blood pressure, BMI, cholesterol, glycated haemoglobin)
5. Improvement of the number of self-reported risk factors (physical exercise, diet)
6. Mortality
7. Disability
8. Cognitive decline
9. CAIDE dementia risk-score
10. Physical fitness (short physical performance battery)
11. Depression (15-item Geriatric Depression Scale)
12. Cost-effectiveness
Overall study start date01/01/2015
Completion date01/01/2018

Eligibility

Participant type(s)Patient
Age groupSenior
SexBoth
Target number of participants2600
Total final enrolment2724
Key inclusion criteria1. Age ≥ 65 years
2. Available informant
3. ≥ 2 cardiovascular risk factors and/or manifest cardiovascular disease defined as:
3.1. Cardiovascular risk factors:
3.1.1. Hypertension, defined by any of the following:
3.1.1.1. Diagnosis by specialist or GP
3.1.1.2. Currently on anti-hypertensive drugs
3.1.1.3. Baseline BP: if < 80 years: ≥ 140/90 mmHg; if ≥ 80 years: Systolic BP ≥ 160
3.1.2. Dyslipidemia, defined by any of the following:
3.1.2.1. Diagnosis of dyslipidemia by specialist or GP
3.1.2.2. Use of lipid-lowering drug (this will include persons who have no dyslipidemia, but use it after a previous cardiovascular disease; this is acceptable, since these people automatically fulfil inclusion criteria as well)
3.1.2.3. Baseline total cholesterol ≥ 5 mmol/L and/or LDL ≥ 2.5 mmol/L
3.1.3. Overweight, defined by any of the following:
3.1.3.1. BMI ≥ 30
3.1.3.2. Waist circumference men ≥102 cm, women ≥88 cm
3.1.4. Active smoking (self-reported, any tobacco use)
3.1.5. Lack of physical exercise (self-reported) defined as below the WHO norm of 30 minutes 5 times a week (or a total of 150 minutes per week) of intermediate exercise
or
3.2. History of cardiovascular disease:
3.2.1. Stroke/transient ischemic attack (TIA)
3.2.2. Myocardial infarction
3.2.3. Angina pectoris
3.2.4. Peripheral arterial disease
3.2.5. Diabetes mellitus (DM)
Key exclusion criteria1. Previously diagnosed dementia as diagnosed by a GP or specialist
2. Mini Mental State Examination score <24
3. Any condition expected to limit 18-months compliance and follow-up
4. Computer illiteracy, defined as unable to send an email and/or do a simple Google search
5. Severe visual impairment interfering with operating a computer
6. Participating in another randomised controlled trial
Date of first enrolment01/01/2015
Date of final enrolment01/07/2016

Locations

Countries of recruitment

  • Finland
  • France
  • Netherlands

Study participating centre

Academic Medical Centre
Amsterdam
1105 AZ
Netherlands

Sponsor information

Academic Medical Centre Amsterdam (Netherlands)
Hospital/treatment centre

Meibergdreef 9
Amsterdam
1105 AZ
Netherlands

ROR logo "ROR" https://ror.org/03t4gr691

Funders

Funder type

Government

Seventh Framework Programme, grant agreement No 305374
Government organisation / National government
Alternative name(s)
EC Seventh Framework Programme, European Commission Seventh Framework Programme, EU Seventh Framework Programme, European Union Seventh Framework Programme, FP7

Results and Publications

Intention to publish date15/11/2019
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication of study results in a high-impact peer reviewed journal.
IPD sharing planThe datasets generated during and/or analysed during the current study are/will be available upon request from Dr. E. Richard (e.richard@amc.uva.nl)

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 10/06/2016 Yes No
Statistical Analysis Plan 12/06/2017 27/06/2017 No No
Results article qualitative sub-study results 21/01/2018 Yes No
Results article qualitative sub-study results 06/06/2019 02/06/2020 Yes No
Results article qualitative study results 06/08/2020 10/08/2020 Yes No
Results article results 01/12/2019 17/12/2020 Yes No
Other publications Factors predicting engagement in the intervention 13/12/2021 07/04/2022 Yes No

Additional files

ISRCTN48151589_SAP_12Jun17.pdf
Uploaded 27/06/2017

Editorial Notes

07/04/2022: Publication reference added.
17/12/2020: The following changes were made to the trial record:
1. Publication reference added.
2. The total final enrolment was added.
10/08/2020: Publication reference added.
02/06/2020: Publication reference added.
28/10/2019: The intention to publish date was changed from 31/03/2019 to 15/11/2019.
17/08/2018: Publication reference added.
27/06/2017: Uploaded statistical analysis plan. Please note that this was originally submitted on June 13th 2017.
13/06/2017: The recruitment end date has been updated from 01/07/2017 to 01/07/2016. The Plain English summary has been reviewed and updated to reflect the trial end date. Added participant level data sharing statement.
08/07/2016: The publication and dissemination plan and availability of participant level data have been added.
04/07/2016: The recruitment end date has been updated from 01/06/2017 to 01/07/2017 and the overall trial end date has been updated from 01/06/2017 to 01/01/2018. In addition, the target number of participants has changed from 4250 to 2600.
13/06/2016: Publication reference added.
24/03/2016: Ethics approval information added.