Medication reminder applications to improve adherence in coronary heart disease: a randomised clinical trial

Heart ◽  
2018 ◽  
Vol 105 (4) ◽  
pp. 323-329 ◽  
Author(s):  
Karla Santo ◽  
Anna Singleton ◽  
Kris Rogers ◽  
Aravinda Thiagalingam ◽  
John Chalmers ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medication Adherence ◽  
Usual Care ◽  
Mean Difference ◽  
Care Group ◽  
Improve Medication Adherence ◽  
Significant Difference ◽  
Medication Reminder

ObjectiveThe aim of the MEDication reminder APPs to improve medication adherence in Coronary Heart Disease Study was to evaluate the effectiveness and feasibility of using publicly available high-quality medication reminder applications (apps) to improve medication adherence compared with usual care in patients with coronary heart disease (CHD). An additional aim was to examine whether an app with additional features improved adherence further.MethodsPatients with CHD (n=163) were randomised to one of three groups: (1) usual care, (2) a basic app or (3) an advanced app with interactive/customisable features. The primary analysis compared usual care versus app use on the primary outcome of the 8-item Morisky Medication Adherence Scale (MMAS-8) at 3 months. Secondary outcomes included blood pressure and cholesterol levels.ResultsThe mean age was 57.9 years and 87.7% were male. At 3 months, patients using an app had higher adherence (mean MMAS-8 score 7.11) compared with the usual care group (mean MMAS-8 score 6.63) with a mean difference between groups of 0.47 (95% CI 0.12 to 0.82, p=0.008). There was no significant difference in patients using the basic app versus the advanced app (mean difference −0.16, 95% CI −0.56 to 0.24, p=0.428). There were no significant differences in secondary clinical outcome measures.ConclusionPatients with CHD who used medication reminder apps had better medication adherence compared with usual care, and using apps with additional features did not improve this outcome further. These data suggest medication apps are likely to help patients with chronic health conditions adhere to medicines, but further examination of whether such benefits are sustained is warranted.Clinical trial registration numberACTRN12616000661471; Results.

scholarly journals MEDication reminder APPs to improve medication adherence in Coronary Heart Disease (MedApp-CHD) Study: a randomised controlled trial protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017540 ◽  
Author(s):  
Karla Santo ◽  
Clara K Chow ◽  
Aravinda Thiagalingam ◽  
Kris Rogers ◽  
John Chalmers ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medication Adherence ◽  
Randomised Controlled Trial ◽  
Usual Care ◽  
Usual Care Group ◽  
Controlled Trial ◽  
Care Group ◽  
Randomised Controlled ◽  
Medication Reminder

IntroductionThe growing number of smartphone health applications available in the app stores makes these apps a promising tool to help reduce the global problem of non-adherence to long-term medications. However, to date, there is limited evidence that available medication reminder apps are effective. This study aims to determine the impact of medication reminder apps on adherence to cardiovascular medication when compared with usual care for people with coronary heart disease (CHD) and to determine whether an advanced app compared with a basic app is associated with higher adherence.Methods and analysisRandomised controlled trial with follow-up at 3 months to evaluate the feasibility and effectiveness of medication reminder apps on medication adherence compared with usual care. An estimated sample size of 156 patients with CHD will be randomised to one of three groups (usual care group, basic medication reminder app group and advanced medication reminder app group). The usual care group will receive standard care for CHD with no access to a medication reminder app. The basic medication reminder app group will have access to a medication reminder app with a basic feature of providing simple daily reminders with no interactivity. The advanced medication reminder app group will have access to a medication reminder app with additional interactive and customisable features. The primary outcome is medication adherence measured by the eight-item Morisky Medication Adherence Scale at 3 months. Secondary outcomes include clinical measurements of blood pressure and cholesterol levels, and medication knowledge. A process evaluation will also be performed to assess the feasibility of the intervention by evaluating the acceptability, utility and engagement with the apps.Ethics and disseminationEthical approval has been obtained from the Western Sydney Local Health Network Human Research Ethics Committee (AU/RED/HREC/1/WMEAD/3). Study findings will be disseminated via usual scientific forums.Trial registration numberACTRN12616000661471; Pre-results

Abstract 112: Depression Does Not Predict Longitudinal Medication Adherence in an Acute Coronary Syndrome Population

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Katherine M Fagan ◽  
Anne Lambert-Kerzner ◽  
Evan P Carey ◽  
Eric J Del Giacco ◽  
Renee Mihalko-Corbitt ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Acute Coronary Syndrome ◽  
Medication Adherence ◽  
Usual Care ◽  
Hospital Discharge ◽  
Beta Blockers ◽  
Care Group ◽  
Improve Medication Adherence ◽  
Coronary Syndrome ◽  
The Mean

Background: Prior studies have shown that depression may be associated with longitudinal medication non-adherence for patients with chronic cardiovascular disease. However, little is known about depression and medication adherence following acute coronary syndrome (ACS) hospitalization. Our objective was to assess whether depression was associated with longitudinal medication adherence following ACS among Veterans enrolled in a clinical trial designed to improve medication adherence. Methods: Patients included in the current analysis were enrolled in the MEDICATION study, which tested a multifaceted intervention versus usual care to improve medication adherence in the year following ACS hospitalization at 4 VA Medical Centers. Depression was assessed using the Patient Health Questionnaire (PHQ-9) prior to hospital discharge based on a score of ≥10. Medication adherence was assessed for 4 classes of cardioprotective medications (Statins, ACEI/ARBs, Clopidogrel, and Beta Blockers) in the 12-months following hospital discharge using pharmacy refill data. A proportion of days covered (PDC) was calculated based on the 4 classes of medications, and adherent patients were categorized based on a PDC ≥0.80. Then, we assessed the association between depression and medication adherence in the year after ACS hospitalization. Results: Of the 241 patients, the average age was 63.9 years, mean BMI was 30.9 kg/m 2 , and they had a number of comorbidities: 45.2% had diabetes and 65.6% had a history of coronary artery disease. The mean PHQ-9 score was 8.2 and 35.4% had depression (PHQ≥10) prior to discharge, with no difference in the prevalence of depression between treatment groups. In the year after ACS hospitalization, the mean PDC was 0.90 for all patients and there was no difference between depressed (PDC=0.91) and non-depressed patients (PDC=0.90). Among patients in the usual care group, there was also no difference in adherence between depressed (PDC=0.88) and non-depressed (PDC=0.86) patients. Conclusions: In this cohort of patients enrolled in a clinical trial, depression was present in 1 out of 3 patients during ACS hospitalization but not associated with medication adherence in the year after hospital discharge. A potential explanation for the lack of association between depression and adherence may be related to the overall high adherence rates found in the MEDICATION study. It will be important to assess whether depression is a marker of medication non-adherence in other ACS cohorts.

scholarly journals Evaluating Reach, Acceptability, Utility, and Engagement with An App-Based Intervention to Improve Medication Adherence in Patients with Coronary Heart Disease in the MedApp-CHD Study: A Mixed-Methods Evaluation

2019 ◽  
Vol 7 (6) ◽  
pp. 68 ◽  
Author(s):  
Karla Santo ◽  
Anna Singleton ◽  
Clara K Chow ◽  
Julie Redfern
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mixed Methods ◽  
Medication Adherence ◽  
Analytical Data ◽  
Improve Medication Adherence ◽  
Mixed Methods Evaluation ◽  
Patient Screening ◽  
Clinical Measurements ◽  
Medication Reminder

Objective: The aim of this study was to assess the reach, acceptability, utility, and engagement with the apps that were used in the MEDication reminder APPlications (apps) to improve medication adherence in Coronary Heart Disease (MedApp-CHD) study, a randomised clinical trial to improve medication adherence, using a mixed-methods approach. Methods: The MedApp-CHD study randomised 163 patients with coronary heart disease (CHD) to one of three groups: (i) usual care (n = 56), (ii) a basic medication reminder app (n = 54), or (iii) an advanced medication reminder app (n = 53). For this mixed-methods evaluation, the data sources included patient screening logs, feedback questionnaires collected at three-month follow-up, focus groups discussions, and analytical data from the app software. Results: Ninety-four percent (98/104) of participants who received a medication reminder app completed the three-month feedback questionnaire and 15 participated in the focus group discussions. The themes that were identified included that participants (i) found the medication reminders useful in reminding them to take the medications on the correct time every day, (ii) liked having the medication list as an easily-accessible record of medications’ names and dosages, (iii) reported being likely to continue to use the apps after the study completion, (iv) would be likely to recommend the apps to their family and friends, and (v) those who used the clinical measurements feature found it useful as a tool to track and graph the blood pressure and glucose levels over time (especially those with diabetes and/or hypertension). In addition, analytical data from the app software demonstrated that the participants used the medication-related features more than the clinical measurements feature. Furthermore, data from the patient screening logs showed that the main reason for exclusion, other than not meeting the CHD criteria, was not having a suitable smartphone, and those that were excluded for this reason were older and had a higher proportion of females than those enrolled in the study. Conclusion: This study provides important insights regarding the features that are most useful in apps that aim to improve medication adherence. This mixed-methods evaluation suggests that, currently, young male patients with CHD are more likely to use such apps, that the apps were well-accepted and useful in reminding the patients to take the medications, and that the patients were engaged in regularly using the apps.

scholarly journals Effectiveness of mobile phone-based self-management interventions for medication adherence and change in blood pressure in patients with coronary heart disease: A systematic review and meta-analysis

2019 ◽  
Vol 19 (3) ◽  
pp. 192-200 ◽  
Author(s):  
Yun Shan Sua ◽  
Ying Jiang ◽  
David R Thompson ◽  
Wenru Wang
Keyword(s):  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medication Adherence ◽  
Mobile Phone ◽  
Mean Difference ◽  
Self Management ◽  
Medium Size ◽  
Significant Heterogeneity ◽  
Management Interventions

Aims: The aim of this study was to synthesise and evaluate the effectiveness of mobile phone-based self-management interventions for medication adherence and change in blood pressure in patients with coronary heart disease. Methods: Relevant randomised controlled trials evaluating mobile phone-based self-management interventions for medication adherence and/or change in blood pressure in coronary heart disease patients were identified by searching six electronic databases (PubMed, Cochrane, CINAHL, ProQuest, Scopus and EMBASE) from January 2008 to January 2019. The trials were screened, data were extracted and quality was assessed by two independent reviewers. Meta-analyses were performed for different outcomes while narrative syntheses were conducted for studies that could not be pooled or when there was the presence of high heterogeneity. Results: Fifteen trials were included in this review, of which 11 of these trials were meta-analysed. Mobile phone-based self-management interventions were associated with a statistically significant reduction in diastolic blood pressure (combined mean difference of −1.99 (95% confidence interval (CI) –3.20 to −0.78; P=0.0001)). However, the combined effect on medication adherence (medium size effect of d=0.72 (95% CI −0.32 to 1.75; P=0.17)) and change in systolic blood pressure (combined mean difference of −1.08 (95% CI −5.51 to 3.35; P=0.63)) was not statistically significant. There was significant heterogeneity among the trials reviewed. Conclusion: Mobile phone-based self-management interventions have the potential to improve self-management and adherence in patients with coronary heart disease but better designed, conducted and reported trials are needed to demonstrate this.

scholarly journals Multimodal Diagnostics of Microrheologic Alterations in Blood of Coronary Heart Disease and Diabetic Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 76
Author(s):  
Anastasia Maslianitsyna ◽  
Petr Ermolinskiy ◽  
Andrei Lugovtsov ◽  
Alexandra Pigurenko ◽  
Maria Sasonko ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Red Blood Cells ◽  
Blood Cells ◽  
Optical Methods ◽  
Diabetic Patients ◽  
Aggregation Index ◽  
Significant Difference

Coronary heart disease (CHD) has serious implications for human health and needs to be diagnosed as early as possible. In this article in vivo and in vitro optical methods are used to study blood properties related to the aggregation of red blood cells in patients with CHD and comorbidities such as type 2 diabetes mellitus (T2DM). The results show not only a significant difference of the aggregation in patients compared to healthy people, but also a correspondence between in vivo and in vitro parameters. Red blood cells aggregate in CHD patients faster and more numerously; in particular the aggregation index increases by 20 ± 7%. The presence of T2DM also significantly elevates aggregation in CHD patients. This work demonstrates multimodal diagnostics and monitoring of patients with socially significant pathologies.

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