Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .
The WHICH? trial: rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients.
AIMS To describe the rationale and design of the Which Heart failure Intervention is most Cost-effective & consumer friendly in reducing Hospital care ( WHICH ? ) trial . METHODS WHICH ? is a pragmatic , multicentre , r and omized controlled trial that seeks to determine if multidisciplinary management of chronic heart failure ( CHF ) patients post-acute hospitalization delivered in a patient 's own home is superior to care delivered via a specialist CHF outpatient clinic . The composite primary endpoint is all-cause , unplanned recurrent hospitalization or death during 12 - 18 months of follow-up . Of 688 eligible patients , 280 patients ( 73 % male and 66 % principal diagnosis of CHF ) with a mean age of 71 ± 14 years have been r and omized to home- ( n = 143 ) or clinic-based ( n = 137 ) post-discharge management . This will provide 80 % power ( two-sided alpha of 0.05 ) to detect a 15 % absolute difference in both the primary end-point and rate of all-cause hospital stay . Preliminary data suggest that the two groups are well matched in nearly all baseline socio-economic and clinical parameters . The majority of patients have significant co-morbidity , including hypertension ( 63 % ) , coronary artery disease ( 55 % ) , and atrial fibrillation ( 53 % ) with an accordingly high Charlson Index of Comorbidity Score ( 6.1 ± 2.4 ) . PERSPECTIVE Despite its relatively small size , the WHICH ? trial is well placed to examine the relative impact of two of the most commonly applied forms of face-to-face management design ed to reduce recurrent hospitalization and prolong survival in CHF patients
Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .