Table 1 EMPOWER-SUSTAIN Self-Management e-Health Intervention
Chronic Care Model elements | Crucial components | Intervention |
|---|---|---|
Decision support | Decision support for physicians to translate CPG recommendations into day-to-day clinical practice [48,49,50] | EMPOWER-SUSTAIN Training Workshop for PCPs to use web-based desktop and mobile applications and to reinforce the use of relevant CPG for management and prescribing |
Self-management support | Self-management support to facilitate patient activation and behaviour change [51,52,53,54] | PCPs to support and empower patients with knowledge, skills and confidence in using the EMPOWER-SUSTAIN mobile application and the EMPOWER-SUSTAIN Global CV Risks Self-Management Booklet using the persuasive technology approach |
Delivery system design | Delivery system design through the EMPOWER-SUSTAIN clinic to improve continuity of care and patient–physician relationship [55,56,57] | The EMPOWER-SUSTAIN Self-Management e-Health Intervention will be delivered by PCP at baseline and 3-month and 6-month follow-up visits in the EMPOWER-SUSTAIN clinic to ensure continuity of care and sustainability |