Mobile health to improve adherence and patient experience in heart transplantation recipients : The mheart trial
Gomis-Pastor, Mar (Institut d'Investigació Biomèdica Sant Pau)
Mirabet Pérez, Sonia (Institut d'Investigació Biomèdica Sant Pau)
Roig Minguell, Eulàlia (Institut d'Investigació Biomèdica Sant Pau)
Brossa Loidi, Vicens (Institut d'Investigació Biomèdica Sant Pau)
López-López, Laura (Institut d'Investigació Biomèdica Sant Pau)
Ros Abarca, Sandra (Institut d'Investigació Biomèdica Sant Pau)
Tugas, E.G. (Hospital de la Santa Creu i Santa Pau)
Mas-Malagarriga, Núria (Institut d'Investigació Biomèdica Sant Pau)
Mangues, Ma Antonia (Institut d'Investigació Biomèdica Sant Pau)

Fecha:	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.
Nota:	Altres ajuts: Amgen SL, General Pharmaceutical Council of Barcelona i Astellas Pharma US
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Heart transplantation ; Medication therapy management ; Immunosuppression ; Treatment outcome ; Interdisciplinary health team ; Patient-reported outcome measures ; Behavioral sciences ; Treatment adherence and compliance ; Telemedicine ; Mobile health
Publicado en:	Healthcare, Vol. 9 Núm. 4 (2021) , p. 463, ISSN 2227-9032

DOI: 10.3390/healthcare9040463
PMID: 33919899

20 p, 2.6 MB

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Documentos de investigación > Documentos de los grupos de investigación de la UAB > Centros y grupos de investigación (producción científica) > Ciencias de la salud y biociencias > Institut de Recerca Sant Pau
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