An mHealth intervention to improve medication adherence among patients with coronary heart disease in China: Development of an intervention

Abstract

Objectives With this study, we aimed to develop a mobile technology (mHealth) intervention to improve medication adherence among patients with coronary heart disease (CHD). Methods The study was conducted in two phases with CHD patients from a Cardiology Department of a hospital located in China. Each phase was independent from the other. Phase 1 tested the integration of the two apps — “WeChat” and “BB Reminder” — as an mHealth intervention. All participants received the same educational materials via WeChat every two days. Participants in the experimental group received a reminder from BB Reminder for every dose of their medications. The duration of Phase 1 was 30 days for each participant. Phase 2 refined the intervention, in which educational materials were sent every five days rather than every two days, and medication-taking reminders were sent daily rather than every dose. Results In Phase 1, an mHealth intervention was developed by integrating two mobile apps. In Phase 2, medication adherence increased at 30-day follow-up in both groups compared to baseline. At the 30-day follow-up, the mean of the decrease in medication non-adherence score in the experimental group ( M = −1.35, SD = 2.18, n = 36) was more than the decrease in control group ( M = −0.69, S D = 1.58, n = 36), which means the medication adherence improved more in the experimental group. Conclusion The feasibility of using mHealth to remind CHD patients to take their medications is high.

Cardioprotective medication adherence among patients with coronary heart disease in China: a systematic review

“…Patients’ lack of follow-up care may also be related to the healthcare system in China. The included studies did not provide direct evidence to support this point, but empirical evidence from other studies has shown that patients with CHD prefer to use hospitals rather than local primary healthcare clinics for treatment 48. Under the current system, most physicians in large hospitals are required to see a great number of patients each day, and they may not have a sufficient amount of time to provide advice to patients on medication adherence.…”

What Motivates Chinese Young Adults to Use mHealth?

“…However, their survey results showed that communication effectiveness significantly influenced the adoption of SMS but did not have a significant effect on perceived usefulness. Nevertheless, researchers [7,8] indicated that communication effectiveness facilitates interactions between people and health care providers, thus influencing perceived usefulness and people's intention to use mHealth. Thus, we posit that: Trustworthiness is another major contextual issue as information and communications technologies become ubiquitous and pervasive [44,45].…”

“…In the US, around one third of cell phone users have accessed health information, including behavioral health issues, frequently using mobile devices [5,6]. In China, mHealth has been used to improve communications between patients and health care providers, promote public health awareness and health education, and enhance the efficiency of medical services and public health campaigns [7,8]. mHealth is becoming more and more important because China's number of mobile Internet users has increased from 346 million in 2011 to 817 million in 2018 [9,10], and the number of active mHealth users was 466 million in the first quarter of 2019 [11].…”

Optimizing the Application of Mobile Health as a Prevention of Recurrence in Patients with Cardiovascular Disease: A Literature Review

“…This study involved 33 patients with cardiovascular disease with SaltSwitch Intervention and 33 participants in the control group, showing no significant difference as evidenced by the statistical results (P > 0.05) [15]. In contrast to a research conducted by Chen S, 2018 [13].…”

“…Phase 2: Material on health education was given every five days and reminders to take medicine were given every day. The results showed that there was an increase in medication adherence of the participants [13].…”