Evidence map›Paper›PMID 28963313›Full record

Trial reportBMJ open2017

Effect of a combined education and eHealth programme on the control of oral anticoagulation patients (PORTALS study): a parallel cohort design in Dutch primary care.

Esther P W A Talboom-Kamp, Noortje A Verdijk, Marise J Kasteleyn, Lara M Harmans, Irvin J S H Talboom, Mattijs E Numans, Niels H Chavannes

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. A Systematic Review on Mobile Health Applications' Education Program for Patients Taking Oral Anticoagulants.International journal of environmental research and public health · 2021
    Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Article
  7. Review
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Esther P W A Talboom-KampPublic Health and Primary Care Department, Leiden University Medical Centre, Leiden, The Netherlands.
Noortje A VerdijkPublic Health and Primary Care Department, Leiden University Medical Centre, Leiden, The Netherlands.
Marise J KasteleynPublic Health and Primary Care Department, Leiden University Medical Centre, Leiden, The Netherlands.
Lara M HarmansDepartment of Thrombosis Service Centre, Saltro Diagnostic Centre, Utrecht, The Netherlands.
Irvin J S H TalboomDepartment of Information Management, Caregroup DOH, Eindhoven, The Netherlands.
Mattijs E NumansPublic Health and Primary Care Department, Leiden University Medical Centre, Leiden, The Netherlands.
Niels H ChavannesPublic Health and Primary Care Department, Leiden University Medical Centre, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo analyse the effect on therapeutic control and self-management skills of the implementation of self-management programmes, including eHealth by e-learning versus group training.

settingPrimary Care Thrombosis Service Center.

participantsOf the 247 oral anticoagulation therapy (OAT) patients, 63 started self-management by e-learning, 74 self-management by group training and 110 received usual care. INTERVENTION AND

methodsParallel cohort design with two randomised self-management groups (e-learning and group training) and a group receiving usual care. The effect of implementation of self-management on time in therapeutic range (TTR) was analysed with multilevel linear regression modelling. Usage of a supporting eHealth platform and the impact on self-efficacy (Generalised Self-Efficacy Scale (GSES)) and education level were analysed with linear regression analysis. After intervention, TTR was measured in three time periods of 6 months.

main outcome measures(1) TTR, severe complications,(2) usage of an eHealth platform,(3) GSES, education level.

resultsAnalysis showed no significant differences in TTR between the three time periods (p=0.520), the three groups (p=0.460) or the groups over time (p=0.263). Comparison of e-learning and group training showed no significant differences in TTR between the time periods (p=0.614), the groups (p=0.460) or the groups over time (p=0.263). No association was found between GSES and TTR (p=0.717) or education level and TTR (p=0.107). No significant difference was found between the self-management groups in usage of the platform (0-6 months p=0.571; 6-12 months p=0.866; 12-18 months p=0.260). The percentage of complications was low in all groups (3.2%; 1.4%; 0%).

conclusionsNo differences were found between OAT patients trained by e-learning or by a group course regarding therapeutic control (TTR) and usage of a supporting eHealth platform. The TTR was similar in self-management and regular care patients. With adequate e-learning or group training, self-management seems safe and reliable for a selected proportion of motivated vitamin K antagonist patients. TRIAL REGISTRATION NUMBER: NTR3947.

Indexed as

TelemedicineAdministration, OralAgedAnticoagulantsCohort StudiesFemaleHumansInternational Normalized RatioLinear ModelsMaleMiddle AgedNetherlandsPrimary Health CarePsychotherapy, GroupSelf CareThrombosisAnticoagulantseHealthe-learning–oral anticoagulationself-efficacyself-managementself-monitoring.thrombosisTTR

Identifiers

PMID28963313
PMCPMC5623459

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.