Mobile health to improve adherence and patient experience in heart transplantation recipients : The mheart trial
Gomis-Pastor, Mar ![Identificador ORCID](/img/uab/orcid.ico)
(Institut d'Investigació Biomèdica Sant Pau)
Mirabet Pérez, Sonia ![Identificador ORCID](/img/uab/orcid.ico)
(Institut d'Investigació Biomèdica Sant Pau)
Roig Minguell, Eulàlia (Institut d'Investigació Biomèdica Sant Pau)
Brossa Loidi, Vicens ![Identificador ORCID](/img/uab/orcid.ico)
(Institut d'Investigació Biomèdica Sant Pau)
López-López, Laura ![Identificador ORCID](/img/uab/orcid.ico)
(Institut d'Investigació Biomèdica Sant Pau)
Ros Abarca, Sandra ![Identificador ORCID](/img/uab/orcid.ico)
(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)
Data: |
2021 |
Resum: |
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 |
Drets: |
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Llengua: |
Anglès |
Document: |
Article ; recerca ; Versió publicada |
Matèria: |
Heart transplantation ;
Medication therapy management ;
Immunosuppression ;
Treatment outcome ;
Interdisciplinary health team ;
Patient-reported outcome measures ;
Behavioral sciences ;
Treatment adherence and compliance ;
Telemedicine ;
Mobile health |
Publicat a: |
Healthcare, Vol. 9 Núm. 4 (2021) , p. 463, ISSN 2227-9032 |
DOI: 10.3390/healthcare9040463
PMID: 33919899
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Registre creat el 2022-12-20, darrera modificació el 2023-11-30