Comparing Mobile Health Strategies to Improve Medication Adherence for Veterans With Coronary Heart Disease (Mobile4Meds): Protocol for a Mixed-Methods Study.
Comparing Mobile Health Strategies to Improve Medication Adherence for Veterans With Coronary Heart Disease (Mobile4Meds): Protocol for a Mixed-Methods Study.
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DOI：
10.2196/resprot.7327
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发表时间：
2017-07-18
影响因子：
1.7
通讯作者：
Whooley MA
中科院分区：
文献类型：
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作者：
Park LG;Collins EG;Shim JK;Whooley MA
坚持服用抗血小板药物对于预防经皮冠状动脉介入治疗(PCI)后危及生命的并发症(如支架血栓形成)至关重要，但12个月内不坚持服药的比率从21-57%不等。通过短信或移动应用程序提供的移动干预代表了一种实用且廉价的战略，以促进行为改变和提高服药依从性。Mobile4Meds的研究试图确定，与为所有退伍军人提供的教育网站控件相比，短信或移动应用程序是否可以提高急性冠脉综合征(ACS)或冠状动脉介入治疗(PCI)患者对抗血小板治疗的依从性。这项研究的三个目的是：(1)确定对短信内容和频率的偏好，以通过焦点小组促进服药依从性；(2)通过对所有商用的服药依从性应用程序和以可用性为中心的焦点小组的内容分析，确定最以患者为中心的促进服药依从性的应用程序；以及(3)通过随机临床试验(RCT)比较退伍军人对急性冠脉综合征/介入治疗后抗血小板药物的依从性。我们将使用混合方法设计，使用焦点小组来实现第一个和第二个目标(N=32)。患者在被随机分配到三组中的一组后将被跟踪12个月：(1)定制短信，(2)移动应用程序，或(3)网站对照组(N=225)。用药依从性将通过电子监测设备、药房记录和自我报告进行衡量。目前正在进行重点小组的登记工作。我们预计在2018年初招募患者参加RCT。使用退伍军人设计的方案来确定移动技术的有效性，以促进服药依从性，将对退伍军人健康和公共健康产生重大影响，特别是对于患有需要严格遵守服药要求的慢性病患者。ClinicalTrials.gov NCT03022669
Adherence to antiplatelet medications is critical to prevent life threatening complications (ie, stent thrombosis) after percutaneous coronary interventions (PCIs), yet rates of nonadherence range from 21-57% by 12 months. Mobile interventions delivered via text messaging or mobile apps represent a practical and inexpensive strategy to promote behavior change and enhance medication adherence. The Mobile4Meds study seeks to determine whether text messaging or a mobile app, compared with an educational website control provided to all Veterans, can improve adherence to antiplatelet therapy among patients following acute coronary syndrome (ACS) or PCI. The three aims of the study are to: (1) determine preferences for content and frequency of text messaging to promote medication adherence through focus groups; (2) identify the most patient-centered app that promotes adherence, through a content analysis of all commercially available apps for medication adherence and focus groups centered on usability; and (3) compare adherence to antiplatelet medications in Veterans after ACS/PCI via a randomized clinical trial (RCT). We will utilize a mixed-methods design that uses focus groups to achieve the first and second aims (N=32). Patients will be followed for 12 months after being randomly assigned to one of three arms: (1) customized text messaging, (2) mobile app, or (3) website-control groups (N=225). Medication adherence will be measured with electronic monitoring devices, pharmacy records, and self-reports. Enrollment for the focus groups is currently in progress. We expect to enroll patients for the RCT in the beginning of 2018. Determining the efficacy of mobile technology using a Veteran-designed protocol to promote medication adherence will have a significant impact on Veteran health and public health, particularly for individuals with chronic diseases that require strict medication adherence. ClinicalTrials.gov NCT03022669