| Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) | |
| Alternative Title | Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) |
| Liu ChongYang1; Du JunZhe1; Rao ChenFei1; Zhang Heng1; Li HanNing1; Zhao Yan1; Yang LiMeng2; Li Xi1; Li Jing1; Wang Jue4; Wang HuiShan5; Liu ZhiGang6; Cheng ZhaoYun7; Zheng Zhe1 | |
| 2018 | |
| Source Publication | Chinese Medical Journal
 |
| ISSN | 0366-6999 |
| Volume | 131Issue:12Pages:1480-1489 |
| Abstract | Background: Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting (CABG). However, medication adherence after CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. Methods: The Measurement and Improvement Studies of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1:1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage medication adherence in the intervention group through a health self-management program initiated during hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac educational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization. Discussion: Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model for outpatient health self-management that could be translated to various chronic diseases and widely disseminated across resource-limited settings. Trial Registration: https://clinicaltrials.gov (NCT02432469). |
| Other Abstract | Background: Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting (CABG). However, medication adherence after CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. Methods: The Measurement and Improvement Studies of Surgical Coronary Revascularization: Medication Adherence (MISSION-2) study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1:1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage medication adherence in the intervention group through a health self-management program initiated during hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac educational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization. Discussion: Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model for outpatient health self-management that could be translated to various chronic diseases and widely disseminated across resource-limited settings. Trial Registration: https://clinicaltrials.gov (NCT02432469). |
| Keyword | Coronary Artery Bypass Grafting Medicine R Medication Adherence Mobile Applications Mobile Health Secondary Prevention |
| Indexed By | CSCD |
| Language | 英语 |
| Funding Project | [Ministry of Science and Technology of China] ; [Prevention and Control Project of Major Chronic Non-infection Disease during the 13th 5-year plan period] ; [capital's funds for health improvement and research] ; [Beijing Municipal Commission of Science and Technology] |
| CSCD ID | CSCD:6266049 |
| Citation statistics | |
| Document Type | 期刊论文 |
| Identifier | http://ir.imr.ac.cn/handle/321006/147410 |
| Collection | 中国科学院金属研究所 |
| Affiliation | 1.中国医学科学院 2.Peking Union Med Coll, Beijing 100073, Peoples R China 3.Chinese Acad Med Sci, Fuwai Hosp, Natl Ctr Cardiovasc Dis, Department Cardiovasc Surg, Beijing 100073, Peoples R China Fuwai Hosp Natl Ctr Cardiovasc Dis Department Cardiovasc Surg 4.Wenzhou Med University, Affiliated Hosp 1, Dept Thorac & Cardiovasc Surg, Wenzhou 325000, Zhejiang, Peoples R China 5.中国科学院金属研究所 6.Peking Union Med Coll, TEDA Int Cardiovasc Hosp, Department Cardiovasc Surg, Tianjin 300457, Peoples R China 7.Fuwai Cent China Cardiovasc Hosp, Henan Prov Peoples Hosp, Department Cardiovasc Surg, Zhengzhou 450003, Henan, Peoples R China |
| Recommended Citation GB/T 7714 | Liu ChongYang,Du JunZhe,Rao ChenFei,et al. Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2)[J]. Chinese Medical Journal,2018,131(12):1480-1489. |
| APA | Liu ChongYang.,Du JunZhe.,Rao ChenFei.,Zhang Heng.,Li HanNing.,...&Zheng Zhe.(2018).Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2).Chinese Medical Journal,131(12),1480-1489. |
| MLA | Liu ChongYang,et al."Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2)".Chinese Medical Journal 131.12(2018):1480-1489. |
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