One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk

In the October 9, 2007, 177, 8, CMAJ issue, Wister and colleagues (1) reported a study about the efficacy of a home-based lifestyle intervention in cardiovascular disease suggesting that “self-care approaches to reduction of cardiovascular disease risk can work when integrated with the primary health care system” (p.865). Many other possibilities for advanced treatment strategies are also feasible in other therapeutic lifestyle and disease-management interventions as indicated by Alter in the same CMAJ issue (2). In order to change and sustain more healthy lifestyles in the treatment of obesity, the Italian TECNOB (TEChnology for OBesity) Project is trying to “move the healthcare where it really needs” through an advanced telehealth counselling approach that can ensure for patients the continuity of treatment at home using a computer based telemedicine platform connected with the clinicians (psychologists, endocrinologists, dieticians) that have already attended the patients inside the hospital. Moreover the TECNOB project is providing patients with some food images using mobile phones: the UMTS connectivity can extend the treatment till the everyday life environments of each patient, traditionally with low compliance in carrying on with weight and diet programs. Patients can experience the possibility to receive “clinically oriented” SMS and MMS improving the reliability of the nutritional prescription, overall in a outpatient setting during the follow-up step of a traditional hospital-based treatment. In fact recent evidence has shown that many pathologies, such as obesity, need to be treated for long period improving patients’ compliance, also using new technologies where necessary (3-6). The technology cannot substitute the medicine but it can improve the efficacy of the traditional clinical protocols. Will the future Hippocrates be a physician or an engineer? References 1. Wister A, Loewen N, Kennedy-Symonds H, McGowan B, McCoy B, Singer J. One-year follow-up of a therapeutic lifestyle intervention targeting cardiovascular disease risk. CMAJ. 2007 Oct 9;177(8):859-65. 2. Alter DA. Therapeutic lifestyle and disease-management interventions: pushing the scientific envelope. CMAJ. 2007 Oct 9;177(8):887-9. 3. Cline AD, Wong M. New frontiers in using telemedicine for nutrition intervention. J Am Diet Assoc. 1999 Nov;99(11):1442-3. 4. Goulis DG, Giaglis GD, Boren SA, et al. Effectiveness of home-centered care through telemedicine applications for overweight and obese patients: a randomized controlled trial. Int J Obes Relat Metab Disord. 2004 Nov;28(11):1391-8. 5. Jeffery RW, Sherwood NE, Brelje K, et al. Mail and phone interventions for weight loss in a managed-care setting: Weigh-To-Be one-year outcomes. Int J Obes Relat Metab Disord. 2003 Dec;27(12):1584-92. 6. Sherwood NE, Jeffery RW, Pronk NP, et al. Mail and phone interventions for weight loss in a managed-care setting: weigh-to-be 2-year outcomes. Int J Obes (Lond). 2006 Oct;30(10):1565-73.

Conflict of Interest:

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