The Effect of a WeChat-Based Tertiary A-Level Hospital Intervention on Medication Adherence and Risk Factor Control in Patients With Stable Coronary Artery Disease: Multicenter Prospective Study

Shi, Boqun; Liu, Xi; Dong, Qiu‐Ting; Yang, Yuxiu; Cai, Zhongxing; Wang, Haoyu; Yin, Dong; Wang, Hongjian; Dou, Kefei; Song, Weihua

doi:10.2196/32548

Cited by 8 publications

(6 citation statements)

References 40 publications

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“…Образовательные вмешательства могут применяться медицинскими работниками (врачами или провизорами) в группах пациентов или индивидуально для устранения барьеров, связанных с намеренной неприверженностью. Данный подход может быть реализован в виде таких стратегий, как выдача печатных материалов, фармацевтическое консультирование и распространение аудиовизуальных материалов [31,32]. Отдельно внимание следует уделить непреднамеренному несоблюдению пациентами режима приёма ЛП.…”

Section: обсуждение / Discussionunclassified

Potential barriers towards optimal medication adherence in out-patients with stable coronary artery disease

Fitilev,

Vozzhaev,

Shkrebniova

et al. 2023

GCP

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Introduction. The results from foreign and local studies demonstrate that more than a half of patients with cardiovascular diseases do not take medication in compliance with doctors’ recommendations. The search for signiﬁcant barriers to optimal medication adherence might improve the development of adherence control measures in patients with stable coronary artery disease (SCAD) in routine clinical practice of primary care.Aim. To study the nature and incidence of potential barriers to optimal medication adherence and their association with social and demographic parameters in patients with SCAD.Methods. This publication describes the fragment of the study “PHARMCARE” in which 123 coronary patients were included. Data on demography, social status, medical history and pharmacotherapy were registered. The barriers to medication adherence were identiﬁed by means of validated scale (questionnaire) SEAMS (Self-Eﬃcacy for Appropriate Medication Use Scale). Data analysis was conducted by descriptive statistics and regression modeling.Results. The analysis of incidence of barriers to medication adherence allowed to identify the list of most signiﬁcant ones: “fear of side eﬀects”, “intake of several diﬀerent medicines each day”, “intake of medicines more than once a day”, “medicines look diﬀerent than usual”, “normal routine gets messed up”, “busy day planned”, “no one reminds to take medicines” and “staying away from home”. More than a third of all the respondents reported at least one of barriers (37%), that was in major cases “fear of side eﬀects” (22%). Linear one-factor modeling revealed association of number of signiﬁcant barriers in patients with level of their education (р=0,009) and presence of partner or caregiver (р=0,001), that was also conﬁrmed by the multivariate model. Less barriers were identiﬁed in coronary patients that had partner or caregiver (р=0,009) and higher education (р=0,045).Conclusion. The study results revealed that the signiﬁcant barriers to optimal medication adherence in out-patients with SCAD were related either to patients’ behavior or to pharmacotherapy proﬁle. Uncertainty in overcoming barriers was most typical for single patients without higher education. The obtained results should be taken into consideration when develop strategies for improvement of medication adherence in patients with SCAD in primary care practice.

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Section: обсуждение / Discussionunclassified

Potential barriers towards optimal medication adherence in out-patients with stable coronary artery disease

Fitilev,

Vozzhaev,

Shkrebniova

et al. 2023

GCP

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“…With the inability to achieve control of BG, diabetes symptoms, and diabetes-related comorbidities through routine follow-up and patient self-management, interventions using mobile technology may improve the treatment effects of diabetes. As an adjuvant to standard self-management, some diabetes apps lead to a clinically remarkable reduction in HbA 1c levels [ 20 ], whereas some apps fail to improve HbA 1c levels [ 26 ]. However, although many diabetes apps have been developed in China, their use rate is only 15.44%.…”

Section: Discussionmentioning

confidence: 99%

Web-Based TangPlan and WeChat Combination to Support Self-management for Patients With Type 2 Diabetes: Randomized Controlled Trial

Xia¹,

Maitiniyazi²,

Chen³

et al. 2022

JMIR Mhealth Uhealth

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Background China has the largest number of patients with type 2 diabetes mellitus (T2DM) in the world. However, owing to insufficient knowledge of self-management in patients with diabetes, blood glucose (BG) control is poor. Most diabetes-related self-management applications fail to bring significant benefits to patients with T2DM because of the low use rate and difficult operation. Objective This study aims to examine the effectiveness of the combination of the self-designed web-based T2DM management software TangPlan and WeChat on fasting BG (FBG), glycated hemoglobin (HbA1c), body weight, blood pressure (BP), and lipid profiles in patients with T2DM over a 6-month period. Methods Participants were recruited and randomized into the TangPlan and WeChat or control groups. Participants in the control group received usual care, whereas the TangPlan and WeChat participants received self-management guidance with the help of TangPlan and WeChat from health care professionals, including BG self-monitoring; healthy eating; active physical exercise; increasing medication compliance; and health education during follow-ups, lectures, or web-based communication. They were also asked to record and send self-management data to the health care professionals via WeChat to obtain timely and effective guidance on diabetes self-management. Results In this study, 76.9% (120/156) of participants completed the 6-month follow-up visit. After the intervention, FBG (mean 6.51, SD 1.66 mmol/L; P=.048), HbA1c (mean 6.87%, SD 1.11%; P<.001), body weight (mean 66.50, SD 9.51 kg; P=.006), systolic BP (mean 127.03, SD 8.00 mm Hg; P=.005), diastolic BP (mean 75.25, SD 5.88 mm Hg; P=.03), serum low-density lipoprotein cholesterol (mean 2.50, SD 0.61 mmol/L; P=.006), and total cholesterol (mean 4.01, SD 0.83 mmol/L; P=.02) in the TangPlan and WeChat group were all significantly lower, whereas serum high-density lipoprotein cholesterol (mean 1.20, SD 0.25 mmol/L; P=.01) was remarkably higher than in those in the control group. Compared with the baseline data, significance was found in the mean change in FBG (95% CI −0.83 to −0.20; P=.002), HbA1c (95% CI −1.92 to −1.28; P<.001), body weight (95% CI −3.13 to −1.68; P<.001), BMI (95% CI −1.10 to −0.60; P<.001), systolic BP (95% CI −7.37 to −3.94; P<.001), diastolic BP (95% CI −4.52 to −2.33; P<.001), triglycerides (95% CI −0.16 to −0.03; P=.004), serum low-density lipoprotein cholesterol (95% CI −0.54 to −0.30; P<.001), and total cholesterol (95% CI −0.60 to −0.34; P<.001) in the TangPlan and WeChat group but not in the control group (P=.08-.88). Conclusions Compared with usual care for patients with T2DM, the combination of TangPlan and WeChat was effective in improving glycemic control (decrease in HbA1c and BG levels) and serum lipid profiles as well as reducing body weight in patients with T2DM after 6 months. Trial Registration Chinese Clinical Trial Registry ChiCTR2000028843; https://tinyurl.com/559kuve6

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“…Moreover, expansion of such education and support to CHD but not only diabetes could lead to improved blood pressure control and the potential to reduce adverse cardiovascular events. In fact, smartphone and social media-based cardiac rehabilitation and secondary prevention in CHD could improve 6-min walk distance (17), help quitting drinking and smoking (18), improve medication adherence, and blood pressure control (19). Thus social appassisted education and support could benefit two diseases at a single shot in such situation.…”

Section: Discussionmentioning

confidence: 99%

Effect of social app-assisted education and support on glucose control in patients with coronary heart disease and diabetes mellitus

Zhong

Zhang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundSocial app-assisted education and support may facilitate diabetes self-management. We aim to evaluate the effect of WeChat, a popular social app, on glycemic control in patients with coronary heart disease (CHD) and diabetes mellitus (DM).MethodsWe conducted a parallel-group, open-label, randomized clinical trial that included 160 patients with both CHD and diabetes mellitus from a tertiary hospital in China. The intervention group (n = 80) received educational materials (information on glucose monitoring, drug usage, medication, and lifestyle) and reminders in response to individual blood glucose values via WeChat. The control group (n = 80) received usual care. The primary outcome was a change in glycated hemoglobin (HbA1C) levels over 3 months. Secondary outcomes included fasting blood glucose (FBG), systolic blood pressure, and low-density lipoprotein (LDL) cholesterol from baseline to 3 months. Analysis was conducted using a linear mixed model.ResultsThe intervention group had a greater reduction in HbA1C (−0.85 vs. 0.15%, between-group difference: −1.00%; 95% CI −1.31 to −0.69%; p < 0.001) compared with the control group. Change in fasting blood glucose was larger in the intervention group (−1.53 mmol/L; 95% CI −1.90 to −1.17; p < 0.001) and systolic blood pressure (−9.06 mmHg; 95% CI −12.38 to −5.73; p < 0.001), but not LDL (between-group difference, −0.08 mmol/L; 95% CI −0.22 to 0.05; p = 0.227).ConclusionThe combination of social app with education and support resulted in better glycemic control in patients with CHD and DM. These results suggest that education and support interaction via social app may benefit self-management in CHD and DM.

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The Effect of a WeChat-Based Tertiary A-Level Hospital Intervention on Medication Adherence and Risk Factor Control in Patients With Stable Coronary Artery Disease: Multicenter Prospective Study

Cited by 8 publications

References 40 publications

Potential barriers towards optimal medication adherence in out-patients with stable coronary artery disease

Potential barriers towards optimal medication adherence in out-patients with stable coronary artery disease

Web-Based TangPlan and WeChat Combination to Support Self-management for Patients With Type 2 Diabetes: Randomized Controlled Trial

Effect of social app-assisted education and support on glucose control in patients with coronary heart disease and diabetes mellitus

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