Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial
Por:
Gomis-Pastor, M, Perez, SM, Minguell, ER, Loidi, VB, Lopez, LL, Abarca, SR, Tugas, EG, Mas-Malagarriga, N, Bafalluy, MAM
Publicada:
1 abr 2021
Resumen:
Background Non-adherence after heart transplantation (HTx) is a significant problem. The main objective of this study was to evaluate if a mHealth strategy is more effective than standard care in improving adherence and patients' experience in heart transplant recipients. Methods: This was a single-center, randomized controlled trial (RCT) in adult recipients >1.5 years post-HTx. Participants were randomized to standard care (control group) or to the mHeart Strategy (intervention group). For patients randomized to the mHeart strategy, multifaceted theory-based interventions were provided during the study period to optimize therapy management using the mHeart mobile application. Patient experience regarding their medication regimens were evaluated in a face-to-face interview. Medication adherence was assessed by performing self-reported questionnaires. A composite adherence score that included the SMAQ questionnaire, the coefficient of variation of drug levels and missing visits was also reported. Results: A total of 134 HTx recipients were randomized (intervention N = 71; control N = 63). Mean follow-up was 1.6 (SD 0.6) years. Improvement in adherence from baseline was significantly higher in the intervention group versus the control group according to the SMAQ questionnaire (85% vs. 46%, OR = 6.7 (2.9; 15.8), p-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), p-value = 0.001). Patients' experiences with their drug therapy including knowledge of their medication timing intakes (p-value = 0.019) and the drug indications or uses that they remembered (p-value = 0.003) significantly improved in the intervention versus the control group. Conclusions: In our study, the mHealth-based strategy significantly improved adherence and patient beliefs regarding their medication regimens among the HTx population. The mHeart mobile application was used as a feasible tool for providing long-term, tailor-made interventions to HTx recipients to improve the goals assessed.
Filiaciones:
Gomis-Pastor, M:
Hosp Santa Creu & Sant Pau, IIB St Pau, Pharm Dept, Barcelona 08025, Catalonia, Spain
Perez, SM:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Barcelona 08041, Catalonia, Spain
CIBER Enfermedades Cardiovasc CIBER CV, Barcelona 08041, Catalonia, Spain
Minguell, ER:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Heart Failure & Heart Transplant Unit, Barcelona 08041, Catalonia, Spain
Loidi, VB:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Heart Failure & Heart Transplant Unit, Barcelona 08041, Catalonia, Spain
Lopez, LL:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Heart Failure & Heart Transplant Unit, Barcelona 08041, Catalonia, Spain
Abarca, SR:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Heart Failure & Heart Transplant Unit, Barcelona 08041, Catalonia, Spain
Tugas, EG:
Hosp Santa Creu & Sant Pau, Cardiol Dept, Heart Failure & Heart Transplant Unit, Barcelona 08041, Catalonia, Spain
Mas-Malagarriga, N:
Hosp Santa Creu & Sant Pau, Pharm Dept, Barcelona 08025, Catalonia, Spain
Bafalluy, MAM:
Hosp Santa Creu & Sant Pau, Pharm Dept, Barcelona 08025, Catalonia, Spain
CIBER Bioingn Biomat & Nanomed CIBER BBN, Barcelona 08025, Catalonia, Spain
gold, Green Published
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