Cardiovascular risk self-management in older people: Development and evaluation of an eHealth platform

This thesis describes how self-management of the cardiovascular risk profile could be offered to older people using eHealth. In the near future the number of people with cardiovascular disease or with elevated risk will rapidly increase, partially due to global ageing. Innovative strategies are needed to make cardiovascular risk management more future-proof. Self-management is a promising strategy to stimulate adherence. EHealth provides many opportunities to provide online self-management programmes to large groups of patients. Older people form an important target population, because they often are at high risk for cardiovascular disease and can still benefit from risk reduction. The European project ‘Healthy Ageing Through Internet Counselling in the Elderly’ (HATICE) therefore aims to develop an internetplatform for cardiovascular self-management in older people. The studies described in this thesis have been performed in the context of HATICE. This thesis describes the development of an internet-intervention for cardiovascular self-management in older people (the HATICE-platform) including a systematic review and meta-analysis on the effectiveness of internet-interventions for cardiovascular risk self-management. Further, research on engagement of older people in innovative forms of cardiovascular riskmanagament is described, including an evaluation of the internet-platform. Worldwide, health care systems face large challenges due to the large increase in people with cardiovascular disease or at elevated risk. This thesis provides starting points on how to develop an eHealth application for cardiovascular self-management for older people. The results of this thesis indicate that human support forms an essential component of internet-interventions to increase their effectiveness