Título:
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Mobile health to improve adherence and patient experience in heart transplantation recipients : The mheart trial
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Autor/a:
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Gomis-Pastor, Mar; Mirabet Pérez, Sonia; Roig Minguell, Eulàlia; Brossa Loidi, Vicens; López-López, Laura; Ros Abarca, Sandra; Tugas, E.G.; Mas-Malagarriga, Núria; Mangues, Ma Antonia
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Abstract:
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Altres ajuts: Amgen SL, General Pharmaceutical Council of Barcelona i Astellas Pharma US |
Abstract:
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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. |
Materia(s):
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-Heart transplantation -Medication therapy management -Immunosuppression -Treatment outcome -Interdisciplinary health team -Patient-reported outcome measures -Behavioral sciences -Treatment adherence and compliance -Telemedicine -Mobile health |
Derechos:
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open access
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Tipo de documento:
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Article |
Editor:
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Uri:
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https://ddd.uab.cat/record/269842
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