Department of Physiotherapy, Westmead Hospital, Sydney, New South Wales, Australia
Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
BMJ Open. 2023 Aug 21;13(8):e073621. doi: 10.1136/bmjopen-2023-073621.
Many hospital presentations for acute coronary syndrome (ACS) occur in people previously hospitalised with coronary heart disease (CHD), leading to increased costs and health burden. Secondary prevention education including a prehospital discharge plan is recommended for all individuals to reduce the risk of recurrence. However, many clinicians lack the time or support to provide education, and patients' uptake of secondary prevention programmes is limited. An avatar-based education app is a novel and engaging way to provide self-delivered, evidence-based secondary prevention information during the hospital admission and remains accessible after discharge. This protocol aims to evaluate the effect of an avatar-based education app on individuals with ACS.
This protocol describes a prospective, randomised controlled trial with 3-month follow-up and blinded assessment of 72 participants. Intervention group participants will download the app onto their own device during the hospital admission and independently complete six interactive education modules based on the National Heart Foundation's six steps to cardiac recovery. All participants will receive a text message reminder of the study after 3 weeks. Both groups will receive usual care consisting of bedside education and a pamphlet about cardiac rehabilitation. The primary outcome is knowledge of CHD, assessed using the Coronary Artery Disease Education Questionnaire II. Secondary outcomes include quality of life, response to heart attack symptoms, cardiac-related readmissions and mortality and modifiable cardiac risk factors. Engagement with the app will be evaluated objectively. Intention-to-treat analysis will be conducted, with between-group comparisons and 95% CIs of the primary outcome analysed using analysis of covariance, adjusting for baseline values.
This study protocol has been approved by the Western Sydney Local Health District Human Research Ethics Committee. The results of this study will be disseminated via a peer-reviewed journal and research thesis.
Australian New Zealand Clinical Trials Registry (ACTRN12622001436763).
许多因急性冠状动脉综合征（ACS）到医院就诊的患者之前曾因冠心病（CHD）住院，这导致了医疗成本和健康负担的增加。推荐对所有患者进行二级预防教育，包括制定院前出院计划，以降低复发风险。然而，许多临床医生缺乏时间或支持来提供教育，并且患者对二级预防计划的接受程度有限。基于头像的教育应用程序是一种新颖且引人入胜的方式，可以在住院期间提供自我提供的、基于证据的二级预防信息，并在出院后仍然可以访问。本方案旨在评估基于头像的教育应用程序对 ACS 患者的效果。
本方案描述了一项前瞻性、随机对照试验，随访时间为 3 个月，对 72 名参与者进行盲法评估。干预组参与者将在住院期间将应用程序下载到自己的设备上，并独立完成基于国家心脏基金会的六个心脏康复步骤的六个互动教育模块。所有参与者将在 3 周后收到研究的短信提醒。两组均将接受常规护理，包括床边教育和关于心脏康复的小册子。主要结局是使用冠心病教育问卷 II 评估冠心病知识。次要结局包括生活质量、对心脏病发作症状的反应、与心脏相关的再入院和死亡率以及可改变的心脏危险因素。将对应用程序的参与情况进行客观评估。将进行意向治疗分析，使用协方差分析比较组间差异和 95%置信区间（CI），并根据基线值进行调整。
本研究方案已获得西悉尼地方卫生区人类研究伦理委员会的批准。本研究的结果将通过同行评议的期刊和研究论文进行传播。
澳大利亚和新西兰临床试验注册中心（ACTRN12622001436763）。
