Department of Pharmacy, University Hospital of Lausanne, University of Lausanne, Lausanne, Switzerland.
Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland.
J Med Internet Res. 2021 Aug 30;23(8):e21938. doi: 10.2196/21938.
Secondary prevention strategies after acute coronary syndrome (ACS) presentation with the use of drug combinations are essential to reduce the recurrence of cardiovascular events. However, lack of drug adherence is known to be common in this population and to be related to treatment failure. To improve drug adherence, we developed the "Mon Coeur, Mon BASIC" video. This online video has been specifically designed to inform patients about their disease and their current medications. Interactivity has been used to increase patient attention, and the video can also be viewed on smartphones and tablets.
The objective of this study was to assess the long-term impact of an informative web-based video on drug adherence in patients admitted for an ACS.
This randomized study was conducted with consecutive patients admitted to University Hospital of Lausanne for ACS. We randomized patients to an intervention group, which had access to the web-based video and a short interview with the pharmacist, and a control group receiving usual care. The primary outcome was the difference in drug adherence, assessed with the Adherence to Refills and Medication Scale (ARMS; 9 multiple-choice questions, scores ranging from 12 for perfect adherence to 48 for lack of adherence), between groups at 1, 3, and 6 months. We assessed the difference in ARMS score between both groups with the Wilcoxon rank sum test. Secondary outcomes were differences in knowledge, readmissions, and emergency room visits between groups and patients' satisfaction with the video.
Sixty patients were included at baseline. The median age of the participants was 59 years (IQR 49-69), and 85% (51/60) were male. At 1 month, 51 patients participated in the follow-up, 50 patients participated at 3 months, and 47 patients participated at 6 months. The mean ARMS scores at 1 and 6 months did not differ between the intervention and control groups (13.24 vs 13.15, 13.52 vs 13.68, respectively). At 3 months, this score was significantly lower in the intervention group than in the control group (12.54 vs 13.75; P=.03). We observed significant increases in knowledge from baseline to 1 and 3 months, but not to 6 months, in the intervention group. Readmissions and emergency room visits have been very rare, and the proportion was not different among groups. Patients in the intervention group were highly satisfied with the video.
Despite a lower sample size than we expected to reach, we observed that the "Mon Coeur, Mon BASIC" web-based interactive video improved patients' knowledge and seemed to have an impact on drug adherence. These results are encouraging, and the video will be offered to all patients admitted to our hospital with ACS.
ClinicalTrials.gov NCT03949608; https://clinicaltrials.gov/ct2/show/NCT03949608.
在急性冠状动脉综合征（ACS）发作后使用药物联合进行二级预防策略对于降低心血管事件的复发至关重要。然而，众所周知，该人群中药物依从性普遍较低，并且与治疗失败有关。为了提高药物依从性，我们开发了“我的心，我的 BASIC”视频。这个在线视频专门用于向患者介绍他们的疾病和当前的药物治疗。我们使用了互动性来提高患者的注意力，并且该视频也可以在智能手机和平板电脑上观看。
本研究旨在评估 ACS 患者接受信息丰富的网络视频对药物依从性的长期影响。
这是一项在洛桑大学医院因 ACS 入院的连续患者中进行的随机研究。我们将患者随机分为干预组和对照组。干预组可访问网络视频和与药剂师的简短访谈，对照组接受常规护理。主要结局是在 1、3 和 6 个月时两组之间药物依从性的差异，采用药物补充和用药量表（ARMS；9 个多项选择题，分数从完全依从的 12 分到不依从的 48 分）评估。我们使用 Wilcoxon 秩和检验评估两组之间 ARMS 评分的差异。次要结局包括两组之间知识差异、再入院率和急诊就诊率以及患者对视频的满意度。
在基线时有 60 名患者入组。参与者的中位年龄为 59 岁（IQR 49-69），85%（51/60）为男性。在 1 个月时，51 名患者参加了随访，在 3 个月时，50 名患者参加了随访，在 6 个月时，47 名患者参加了随访。干预组和对照组在 1 个月和 6 个月时的 ARMS 评分均值无差异（分别为 13.24 分和 13.15 分，13.52 分和 13.68 分）。在 3 个月时，干预组的评分明显低于对照组（12.54 分比 13.75 分；P=.03）。我们观察到干预组的知识从基线到 1 个月和 3 个月都有显著增加，但到 6 个月时没有增加。在干预组中，阅读和急诊就诊非常少见，各组之间的比例没有差异。干预组的患者对该视频非常满意。
尽管我们预期达到的样本量比实际小，但我们观察到“我的心，我的 BASIC”网络互动视频提高了患者的知识水平，并似乎对药物依从性产生了影响。这些结果令人鼓舞，该视频将提供给我们医院所有因 ACS 入院的患者。
ClinicalTrials.gov NCT03949608；https://clinicaltrials.gov/ct2/show/NCT03949608。
