Nina Johnston1, Johan Bodegard2, Susanna Jerström2, Johanna Åkesson2, Hilja Brorsson3, Joakim Alfredsson4, Per A Albertsson5, Jan-Erik Karlsson6, Christoph Varenhorst7. 1. Uppsala Clinical Research Center and Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden. 2. AstraZeneca Nordic-Baltic, Södertälje, Sweden. 3. Statisticon AB, Uppsala, Sweden. 4. Department of Cardiology and Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. 5. Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden. 6. Department of Internal Medicine, County Council of Jönköping, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden. 7. Uppsala Clinical Research Center and Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden. Electronic address: christoph.varenhorst@ucr.uu.se.
Abstract
BACKGROUND:Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients. DESIGN: Multicenter, randomized trial. METHODS:A total of 174 ticagrelor-treated MI patients were randomized to either an interactive patient support tool (active group) or a simplified tool (control group) in addition to usual post-MI care. Primary end point was a composite nonadherence score measuring patient-registered ticagrelor adherence, defined as a combination of adherence failure events (2 missed doses registered in 7-day cycles) and treatment gaps (4 consecutive missed doses). Secondary end points included change in cardiovascular risk factors, quality of life (European Quality of Life-5 Dimensions), and patient device satisfaction (System Usability Scale). RESULTS:Patient mean age was 58 years, 81% were men, and 21% were current smokers. At 6 months, greater patient-registered drug adherence was achieved in the active vs the control group (nonadherence score: 16.6 vs 22.8 [P = .025]). Numerically, the active group was associated with higher degree of smoking cessation, increased physical activity, and change in quality of life; however, this did not reach statistical significance. Patient satisfaction was significantly higher in the active vs the control group (system usability score: 87.3 vs 78.1 [P = .001]). CONCLUSIONS: In MI patients, use of an interactive patient support tool improved patient self-reported drug adherence and may be associated with a trend toward improved cardiovascular lifestyle changes and quality of life. Use of a disease-specific interactive patient support tool may be an appreciated, simple, and promising complement to standard secondary prevention.
RCT Entities:
BACKGROUND:Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients. DESIGN: Multicenter, randomized trial. METHODS: A total of 174 ticagrelor-treated MI patients were randomized to either an interactive patient support tool (active group) or a simplified tool (control group) in addition to usual post-MI care. Primary end point was a composite nonadherence score measuring patient-registered ticagrelor adherence, defined as a combination of adherence failure events (2 missed doses registered in 7-day cycles) and treatment gaps (4 consecutive missed doses). Secondary end points included change in cardiovascular risk factors, quality of life (European Quality of Life-5 Dimensions), and patient device satisfaction (System Usability Scale). RESULTS:Patient mean age was 58 years, 81% were men, and 21% were current smokers. At 6 months, greater patient-registered drug adherence was achieved in the active vs the control group (nonadherence score: 16.6 vs 22.8 [P = .025]). Numerically, the active group was associated with higher degree of smoking cessation, increased physical activity, and change in quality of life; however, this did not reach statistical significance. Patient satisfaction was significantly higher in the active vs the control group (system usability score: 87.3 vs 78.1 [P = .001]). CONCLUSIONS: In MI patients, use of an interactive patient support tool improved patient self-reported drug adherence and may be associated with a trend toward improved cardiovascular lifestyle changes and quality of life. Use of a disease-specific interactive patient support tool may be an appreciated, simple, and promising complement to standard secondary prevention.
Authors: María Ángeles Bernal-Jiménez; Germán Calle-Pérez; Alejandro Gutiérrez-Barrios; Livia Gheorghe; Ana María Solano-Mulero; Amelia Rodríguez-Martín; Josep A Tur; Rafael Vázquez-García; María José Santi-Cano Journal: Nutrients Date: 2021-05-27 Impact factor: 5.717
Authors: Pernille Lunde; Birgitta Blakstad Nilsson; Astrid Bergland; Kari Jorunn Kværner; Asta Bye Journal: J Med Internet Res Date: 2018-05-04 Impact factor: 5.428