Web-based and live counseling programs can effectively reduce risk of heart disease for patients at high risk for the disease, and Web-based programs are particularly cost-effective, according to research from the University of North Carolina at Chapel Hill. The work, published online in JAMA Internal Medicine, adds to a growing body of evidence suggesting that nontraditional approaches to health care are becoming ever more important in managing health and disease.

Co-authors of the study from the University of North Carolina Gillings School of Global Public Health include Dr. Carmen Samuel-Hodge, research assistant professor of nutrition; Dr. Kelly Evenson, research professor of epidemiology; Dr. Bryan Weiner, professor of health policy and management; Dr. Shrikant Bangdiwala, professor of biostatistics; and Dr. Alice Ammerman, professor of nutrition and director of the UNC Center for Health Promotion and Disease Prevention (HPDP).

“Following a healthy lifestyle and taking prescribed medications can reduce the risk for heart disease,” said Dr. Thomas Keyserling, lead author of the study. “However, most providers do not have the skills and resources to help their patients achieve these goals. Delivering programs in nontraditional and cost-effective ways gives providers more options to keep patients healthy.”

The primary outcome for the study was change in a calculated score, called the Framingham Risk Score, which predicts the chances of future heart disease events. This score was reduced substantially in both groups at four and 12 months follow-up. Also of note is that several risk factors improved, including blood pressure, blood cholesterol levels, self-reported dietary intake, physical activity, and medication adherence.

In addition to examining health outcomes, the researchers compared the costs of each approach. The in-person counseling session cost $207 per patient, and the Web-based program cost $110 per person. Both interventions were cost-effective by commonly accepted standards, especially the Web-based format. Both intervention approaches were also very well received by participants, with 75 percent saying they would strongly recommend this program to others.

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