Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial
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, ran...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/9/4/463 |
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| author | Mar Gomis-Pastor Sonia Mirabet Perez Eulalia Roig Minguell Vicenç Brossa Loidi Laura Lopez Lopez Sandra Ros Abarca Elisabeth Galvez Tugas Núria Mas-Malagarriga Mª Antonia Mangues Bafalluy |
| author_facet | Mar Gomis-Pastor Sonia Mirabet Perez Eulalia Roig Minguell Vicenç Brossa Loidi Laura Lopez Lopez Sandra Ros Abarca Elisabeth Galvez Tugas Núria Mas-Malagarriga Mª Antonia Mangues Bafalluy |
| author_sort | Mar Gomis-Pastor |
| collection | DOAJ |
| description | 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. <b>Results</b>: 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), <i>p</i>-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), <i>p</i>-value = 0.001). Patients’ experiences with their drug therapy including knowledge of their medication timing intakes (<i>p</i>-value = 0.019) and the drug indications or uses that they remembered (<i>p</i>-value = 0.003) significantly improved in the intervention versus the control group. <b>Conclusions</b>: 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. |
| first_indexed | 2024-03-10T12:19:56Z |
| format | Article |
| id | doaj.art-1074cf8eac944a19a02d28c38246120d |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T12:19:56Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-1074cf8eac944a19a02d28c38246120d2023-11-21T15:34:21ZengMDPI AGHealthcare2227-90322021-04-019446310.3390/healthcare9040463Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart TrialMar Gomis-Pastor0Sonia Mirabet Perez1Eulalia Roig Minguell2Vicenç Brossa Loidi3Laura Lopez Lopez4Sandra Ros Abarca5Elisabeth Galvez Tugas6Núria Mas-Malagarriga7Mª Antonia Mangues Bafalluy8Pharmacy Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, 08025 Barcelona, Catalonia, SpainCardiology Department, Hospital de la Santa Creu i Santa Pau and CIBER de Enfermedades Cardiovasculares (CIBER-CV), 08041 Barcelona, Catalonia, SpainHeart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, 08041 Barcelona, Catalonia, SpainHeart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, 08041 Barcelona, Catalonia, SpainHeart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, 08041 Barcelona, Catalonia, SpainHeart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, 08041 Barcelona, Catalonia, SpainHeart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, 08041 Barcelona, Catalonia, SpainPharmacy Department, Hospital de la Santa Creu i Santa Pau, 08025 Barcelona, Catalonia, SpainPharmacy Department, Hospital de la Santa Creu i Santa Pau and CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 08025 Barcelona, Catalonia, SpainNon-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. <b>Results</b>: 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), <i>p</i>-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), <i>p</i>-value = 0.001). Patients’ experiences with their drug therapy including knowledge of their medication timing intakes (<i>p</i>-value = 0.019) and the drug indications or uses that they remembered (<i>p</i>-value = 0.003) significantly improved in the intervention versus the control group. <b>Conclusions</b>: 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.https://www.mdpi.com/2227-9032/9/4/463heart transplantationmedication therapy managementimmunosuppressiontreatment outcomeinterdisciplinary health teampatient-reported outcome measures |
| spellingShingle | Mar Gomis-Pastor Sonia Mirabet Perez Eulalia Roig Minguell Vicenç Brossa Loidi Laura Lopez Lopez Sandra Ros Abarca Elisabeth Galvez Tugas Núria Mas-Malagarriga Mª Antonia Mangues Bafalluy Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial Healthcare heart transplantation medication therapy management immunosuppression treatment outcome interdisciplinary health team patient-reported outcome measures |
| title | Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial |
| title_full | Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial |
| title_fullStr | Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial |
| title_full_unstemmed | Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial |
| title_short | Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial |
| title_sort | mobile health to improve adherence and patient experience in heart transplantation recipients the mheart trial |
| topic | heart transplantation medication therapy management immunosuppression treatment outcome interdisciplinary health team patient-reported outcome measures |
| url | https://www.mdpi.com/2227-9032/9/4/463 |
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