IMR OpenIR
Quality Measurement and Improvement Study of Surgical Coronary Revascularization: Medication Adherence (MISSION-2)
其他题名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
发表期刊Chinese Medical Journal
ISSN0366-6999
卷号131期号:12页码:1480-1489
摘要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).
其他摘要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).
关键词Coronary Artery Bypass Grafting Medicine R Medication Adherence Mobile Applications Mobile Health Secondary Prevention
收录类别CSCD
语种英语
资助项目[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记录号CSCD:6266049
引用统计
文献类型期刊论文
条目标识符http://ir.imr.ac.cn/handle/321006/147410
专题中国科学院金属研究所
作者单位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
推荐引用方式
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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