TEXT messages to improve MEDication adherence and Secondary prevention (TEXTMEDS) after acute coronary syndrome: a randomised clinical trial protocol

Chow, Clara K; Thiagalingam, Aravinda; Santo, Karla; Kok, Cindy; Thakkar, Jay; Stepien, Sandrine; Billot, Laurent; Jan, Stephen; Joshi, Rohina; Hillis, Graham S.; Brieger, David; Chew, Derek P.; Rådholm, Karin; Atherton, J.; Bhindi, Ravinay; Collins, Nicholas; Coverdale, Steven; Hamilton-Craig, C.; Kangaharan, Nadarajah; Maiorana, Andrew; McGrady, Michelle; Shetty, P.; Thompson, Peter L.; Rogers, A. D.; Redfern, Julie

doi:10.1136/bmjopen-2017-019463

Cited by 23 publications

(29 citation statements)

References 44 publications

(28 reference statements)

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“…An embedded process evaluation, to be published separately, was conducted to explore mechanism(s) of action and to understand more about loss to follow-up. In this study, we could not use text messages, email, or web applications (apps) to support adherence to medication,4950 because contact details, such as mobile phone numbers and email addresses, were not available in the routinely collected administrative data. Text, email, or apps might have been more effective than postal and telephone based interventions, especially if the timing and content of messages could have been personalised, because home telephones and postal mail are increasingly being replaced with digital communications.…”

Section: Discussionmentioning

confidence: 99%

Interventions supporting long term adherence and decreasing cardiovascular events after myocardial infarction (ISLAND): pragmatic randomised controlled trial

Ivers

Schwalm

Bouck

et al. 2020

BMJ

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Objective To test a scalable health system intervention to improve long term adherence to secondary prevention treatments among patients who have had a recent myocardial infarction. Design Three arm, pragmatic randomised controlled trial with blinded outcome assessment. Setting Nine cardiac centres in Ontario, Canada. Participants 2632 patients with obstructive coronary artery disease after a myocardial infarction, identified from a centralised cardiac registry. Interventions Participants were randomised 1:1:1 to receive usual care, five mail-outs developed through a user centred design process, or mail-outs plus phone calls. The phone calls were delivered first by an interactive automated system to screen for non-adherence to treatment. Trained lay health workers followed up as necessary. Interventions were coordinated centrally but delivered from each patient’s hospital site. Main outcome measures Co-primary outcomes were completion of cardiac rehabilitation and adherence to recommended medication. Data were collected by blinded assessors through patient report and from administrative health databases at 12 months. Results 2632 patients (mean age 66, 71% male) were randomised: 878 to the full intervention (mail plus phone calls), 878 to mail only, and 876 to usual care. Of the respondents, 174 (27%) of 643 in the usual care group, 200 (32%) of 628 in the mail only group, and 196 (37%) of 531 allocated to the full intervention completed cardiac rehabilitation (adjusted odds ratio 1.55, 95% confidence interval 1.18 to 2.03). In the mail plus phone group, 11.7%, 6.0%, 14.4%, 32.9%, and 35.0% reported adherence to 0, 1, 2, 3, and 4 drug classes after one year, respectively, in comparison with 12.5%, 6.8%, 13.6%, 30.2%, and 36.8% in the mail only group, and 12.2%, 8.4%, 13.1%, 30.3%, and 36.1% in the usual care group, respectively (mail only v usual care, odds ratio 0.98, 95% confidence interval 0.81 to 1.19; full intervention v usual care, 0.99, 0.82 to 1.20). Conclusions Scalable interventions delivered by mail plus phone can increase completion of cardiac rehabilitation after myocardial infarction but not adherence to medication. More intensive interventions should be tested to improve adherence to medication and to evaluate the association between attendance at cardiac rehabilitation and adherence to medication. Trial registration ClinicalTrials.gov NCT02382731 , registered 9 March 2015 before any patient enrolment.

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Section: Discussionmentioning

confidence: 99%

Interventions supporting long term adherence and decreasing cardiovascular events after myocardial infarction (ISLAND): pragmatic randomised controlled trial

Ivers

Schwalm

Bouck

et al. 2020

BMJ

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“…Similar with previous studies,10 21 we have identified that people with lower degrees of health awareness, such as younger people, or people with lower education level, are less likely to take secondary prevention drugs. Moreover, cost-effective approaches to enhancing patients’ self-management in secondary prevention of CVD is lacking, although the number of relevant studies has markedly increased 25 26. Furthermore, financial barriers may have a negative effect on patients’ adherence.…”

Section: Discussionmentioning

confidence: 99%

Secondary prevention of cardiovascular disease in China

Zhang

et al. 2020

Heart

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ObjectiveWe aimed to estimate the current use of secondary prevention drugs and identify its associated individual characteristics among those with established cardiovascular diseases (CVDs) in the communities of China.MethodsWe studied 2 613 035 participants aged 35–75 years from 8577 communities in 31 provinces in the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, a government-funded public health programme conducted from 2014 to 2018. Participants self-reported their history of ischaemic heart disease (IHD) or ischaemic stroke (IS) and medication use in an interview. Multivariable mixed models with a logit link function and community-specific random intercepts were fitted to assess the associations of individual characteristics with the reported use of secondary prevention therapies.ResultsAmong 2 613 035 participants, 2.9% (74 830) reported a history of IHD and/or IS, among whom the reported use rate either antiplatelet drugs or statins was 34.2% (31.5% antiplatelet drugs, 11.0% statins and 8.3% both). Among the 1 530 408 population subgroups, which were defined by all possible permutations of 16 individual characteristics, reported use of secondary prevention drugs varied substantially (8.4%–60.6%). In the multivariable analysis, younger people, women, current smokers, current drinkers, people without hypertension or diabetes and those with established CVD for more than 2 years were less likely to report taking antiplatelet drugs or statins.ConclusionsThe current use of secondary prevention drugs in China is suboptimal and varies substantially across population subgroups. Our study identifies target populations for scalable, tailored interventions to improve secondary prevention of CVD.

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“…FaceTime has also been used successfully to enforce directly observed therapy remotely, increasing adherence to mycophenolate mofetil in pediatric patients with SLE 18 . Studies are under way to explore the use of mobile health technologies in other chronic diseases such as hypertension 19,20,21 , diabetes 20,22 , cancer treatment 23 , and human immunodeficiency virus 24 , and the findings of these studies may be applicable to the SLE population in enhancing medication adherence.…”

Section: Discussionmentioning

confidence: 99%

Understanding Nonadherence with Hydroxychloroquine Therapy in Systemic Lupus Erythematosus

Liu

Fevrier²,

Goldfien³

et al. 2019

J Rheumatol

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Objective.Hydroxychloroquine (HCQ) is a cornerstone to managing systemic lupus erythematosus (SLE), yet adherence to medication is poor. We sought to measure the association of adherence with 5 “dimensions of adherence” as articulated by the World Health Organization for chronic conditions: the patient’s socioeconomic status, and patient-, condition-, therapy-, and healthcare system–related factors. Our longterm goal is to generate evidence to design effective interventions to increase adherence.Methods.The retrospective cohort study included Kaiser Permanente Northern California patients ≥ 18 years old during 2006–2014, with SLE and ≥ 2 consecutive prescriptions for HCQ. Adherence was calculated from the medication possession ratio and dichotomized as < 80% versus ≥ 80%. Predictor variables were obtained from the electronic medical record and census data. We used multivariable logistic regression to estimate adjusted OR and 95% CI.Results.The study included 1956 patients. Only 58% of patients had adherence ≥ 80%. In adjusted analyses, socioeconomic variables did not predict adherence. Increasing age (65–89 yrs compared with ≤ 39 yrs: OR 1.44, 95% CI 1.07–1.93), white race (p < 0.05), and the number of rheumatology visits in the year before baseline (≥ 3 compared with 0 or 1: OR 1.47, 95% CI 1.18–1.83) were positively associated with adherence. The rheumatologist and medical center providing care were not associated with adherence.Conclusion.At our setting, as in other settings, about half of patients with SLE were not adherent to HCQ therapy. Differences in adherence by race/ethnicity suggest the possibility of using tailored interventions to increase adherence. Qualitative research is needed to elucidate patient preferences for adherence support.

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TEXT messages to improve MEDication adherence and Secondary prevention (TEXTMEDS) after acute coronary syndrome: a randomised clinical trial protocol

Cited by 23 publications

References 44 publications

Interventions supporting long term adherence and decreasing cardiovascular events after myocardial infarction (ISLAND): pragmatic randomised controlled trial

Interventions supporting long term adherence and decreasing cardiovascular events after myocardial infarction (ISLAND): pragmatic randomised controlled trial

Secondary prevention of cardiovascular disease in China

Understanding Nonadherence with Hydroxychloroquine Therapy in Systemic Lupus Erythematosus

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