Effects of interactive patient smartphone support app on drug adherence and lifestyle changes in myocardial infarction patients: A randomized study

Am Heart J. 2016 Aug:178:85-94. doi: 10.1016/j.ahj.2016.05.005. Epub 2016 May 17.

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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adenosine / analogs & derivatives*
  • Adenosine / therapeutic use
  • Aged
  • Body Mass Index
  • Exercise*
  • Female
  • Health Behavior
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Medication Adherence*
  • Middle Aged
  • Mobile Applications*
  • Myocardial Infarction / therapy*
  • Purinergic P2Y Receptor Antagonists / therapeutic use*
  • Risk Reduction Behavior
  • Secondary Prevention / methods
  • Smartphone*
  • Smoking Cessation*
  • Ticagrelor

Substances

  • Purinergic P2Y Receptor Antagonists
  • Ticagrelor
  • Adenosine