Kazi Samia, Truesdale Chloe, Ryan Pauline, Wiesner Glen, Jennings Garry, Chow Clara
The University of Sydney, Sydney, Australia.
Westmead Applied Research Centre, Westmead, Australia.
JMIR Cardio. 2023 Oct 5;7:e43889. doi: 10.2196/43889.
Coronary heart disease (CHD) remains the leading cause of death in Australia, with a high residual risk of repeat events in survivors. Secondary prevention therapy is crucial for reducing the risk of both death and other major adverse cardiac events. The National Heart Foundation of Australia has developed a consumer-facing support program called My Heart, My Life (MHML) to address the gap in the secondary prevention of CHD in Australia. The MHML pilot program supplies advice and support for both patients and their caregivers, and it was conducted over 8 months from November 2019 to June 2020.
This study aims to describe and examine the implementation of a novel multimodality secondary CHD prevention pilot program called MHML, which was delivered through booklets, text messages, emails, and telephone calls.
This pilot study consists of a mixed methods evaluation involving surveys of participants (patients and caregivers) and health professionals, in-depth interviews, and digital communication (SMS text message, electronic direct mail, and call record analytics). This study was performed in people older than 18 years with acute coronary syndrome or angina and their caregivers in 38 Australian hospitals from November 2019 to June 2020 through the National Heart Foundation of Australia web page. The main outcome measures were reach, accessibility, feasibility, barriers, and enablers to implementation of this program.
Of the 1004 participants (838 patients and 164 caregivers; 2 missing), 60.9% (608/1001) were males, 50.7% (491/967) were aged between 45 and 64 years, 27.4% (276/1004) were from disadvantaged areas, 2.5% (24/946) were from Aboriginal or Torres Strait Islander background, and 16.9% (170/1004) reported English as their second language. The participants (patients and their caregivers) and health professionals reported high satisfaction with the MHML program (55/62, 88.7% and 33/38, 87%, respectively). Of the 62 participants who took the survey, 88% (55/62) used the text messaging service and reported a very high level of satisfaction. Approximately 94% (58/62) and 89% (55/62) of the participants were satisfied with the quick guide booklets 1 and 2, respectively; 79% (49/62) were satisfied with the monthly email journey and 71% (44/62) were satisfied with the helpline calls. Most participants reported that the MHML program improved preventive behaviors, that is, 73% (45/62) of them reported that they maintained increased physical activity and 84% (52/62) reported that they maintained a healthy diet even after the MHML program.
The findings of our pilot study suggest that a multimodal support program, including digital, print, phone, and web-based media, for the secondary prevention of CHD is useful and could be a potential means of providing customized at-scale secondary prevention support for survivors of acute coronary syndrome.
冠心病（CHD）仍是澳大利亚的主要死因，幸存者再次发病的残留风险很高。二级预防治疗对于降低死亡风险和其他主要不良心脏事件至关重要。澳大利亚国家心脏基金会制定了一项面向消费者的支持计划，名为“我的心脏，我的生活”（MHML），以弥补澳大利亚冠心病二级预防方面的差距。MHML试点项目为患者及其护理人员提供建议和支持，于2019年11月至2020年6月进行了8个月。
本研究旨在描述和检验一项名为MHML的新型多模式冠心病二级预防试点项目的实施情况，该项目通过宣传册、短信、电子邮件和电话提供。
这项试点研究包括一项混合方法评估，涉及对参与者（患者和护理人员）和卫生专业人员的调查、深入访谈以及数字通信（短信、电子直邮和通话记录分析）。本研究于2019年1月至2020年6月通过澳大利亚国家心脏基金会网页，在澳大利亚38家医院中对年龄超过18岁的急性冠状动脉综合征或心绞痛患者及其护理人员进行。主要结局指标是该项目实施的覆盖范围、可及性、可行性、障碍和促进因素。
在1004名参与者（838名患者和164名护理人员；2名缺失）中，60.9%（608/1001）为男性，50.7%（491/967）年龄在45至64岁之间，27.4%（276/1004）来自弱势地区，2.5%（24/946）具有原住民或托雷斯海峡岛民背景，16.9%（170/1004）将英语作为第二语言。参与者（患者及其护理人员）和卫生专业人员对MHML项目的满意度很高（分别为55/62，88.7%和33/38，87%）。在62名接受调查的参与者中，88%（55/62）使用了短信服务，并报告了非常高的满意度。分别约94%（58/62）和89%（55/62）的参与者对快速指南手册1和2感到满意；79%（49/62）对每月电子邮件推送感到满意，71%（44/62）对热线电话感到满意。大多数参与者报告称MHML项目改善了预防行为，即73%（45/62）的人报告称他们保持了增加的身体活动，84%（52/62）的人报告称即使在MHML项目结束后他们仍保持健康饮食。
我们试点研究的结果表明，一个包括数字、印刷、电话和网络媒体的多模式支持项目对于冠心病的二级预防是有用的，并且可能是为急性冠状动脉综合征幸存者提供定制化大规模二级预防支持的一种潜在方式。
