The Adherence and Knowledge Exchange Heart Disease Medicines study
**Background:** Achieving the WHO goal of 25% reduction in premature mortality from non-communicable diseases by 2025 requires aggressive prevention measures for coronary heart disease (CHD). Some studies suggest the potential impact of using mobile technology to promote secondary intervention of CHD; yet few mobile Health studies have targeted both health care providers and patient.
**Research Question:** Among patients with CHD, does a multifaceted, information technology-enabled intervention directed at both the patient and health care provider increase the medication adherence for secondary prevention?
**Intervention:** The intervention comprises of (1) an easy to use mobile app-based provider-level decision support system to increase the evidence-based medication prescription; (2) automated, evidence-based text messages or voice calls delivered for 12 weeks.
1. Develop a provider-facing mobile application that facilitates prescription of evidence-based medications for patients with established CHD;
2. Develop and contextualize patient-directed text messages/voice calls related to medication adherence for CHD and lifestyle modification;
3. Test the usability of the provider- and patient-facing interventions for increasing adherence to secondary prevention medications for CHD.
The project has completed 12-weeks intervention among 190 recruited coronary heart disease patients in Shanghai and Hainan, China. After the intervention, we observed a significant improvement in medication adherence, decrease of smoking and increase of daily vegetable consumption frequency and community healthcare center visit frequency. The results is not consistent in Shanghai and Hainan due to personal and system reasons, which may affect patients' medication adherence and lifestyles.
The result paper has been submitted to review and the technical development paper entitled as "Development of a mobile phone-based intervention to improve adherence to secondary prevention of coronary heart disease in China" has been published in Journal of Medical Engineering & Technology. A systematic review paper entitled "Effect of Mobile Health Interventions on the Secondary Prevention of Cardiovascular Disease: systematic review and meta-analysis" has been published on Canadian Journal of Cardiology.
Project Policy Impact Description
When pilot tested, shown effective and scaled up, the project has the potential to promote the medication adherence and lifestyle modification among patients for secondary prevention, and thereby to improve patient health.
- McMaster University