title: Effects of interactive patient smartphone support app on drug adherence and lifestyle changes in myocardial infarction patients: A randomized study.
abstract: BACKGROUND
  Patients with myocardial infarction (MI) seldom reach recommended targets for secondary prevention. This study evaluated a smartphone application ("app") aimed at improving treatment adherence and cardiovascular lifestyle in MI patients.
  
  
  METHODS
  Multicenter, randomized trial.
  
  
  METHODS
  A total of 174 ticagrelor-treated MI patients were randomized to either an interactive patient support tool (active group) or a simplified tool (control group) in addition to usual post-MI care. Primary end point was a composite nonadherence score measuring patient-registered ticagrelor adherence, defined as a combination of adherence failure events (2 missed doses registered in 7-day cycles) and treatment gaps (4 consecutive missed doses). Secondary end points included change in cardiovascular risk factors, quality of life (European Quality of Life-5 Dimensions), and patient device satisfaction (System Usability Scale).
  
  
  RESULTS
  Patient mean age was 58 years, 81% were men, and 21% were current smokers. At 6 months, greater patient-registered drug adherence was achieved in the active vs the control group (nonadherence score: 16.6 vs 22.8 [P = .025]). Numerically, the active group was associated with higher degree of smoking cessation, increased physical activity, and change in quality of life; however, this did not reach statistical significance. Patient satisfaction was significantly higher in the active vs the control group (system usability score: 87.3 vs 78.1 [P = .001]).
  
  
  CONCLUSIONS
  In MI patients, use of an interactive patient support tool improved patient self-reported drug adherence and may be associated with a trend toward improved cardiovascular lifestyle changes and quality of life. Use of a disease-specific interactive patient support tool may be an appreciated, simple, and promising complement to standard secondary prevention.
authors: Uppsala Clinical Research Center and Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden.
authors: Nina
authors: N
authors: Johnston
authors: AstraZeneca Nordic-Baltic, Södertälje, Sweden.
authors: Johan
authors: J
authors: Bodegard
authors: AstraZeneca Nordic-Baltic, Södertälje, Sweden.
authors: Susanna
authors: S
authors: Jerström
authors: AstraZeneca Nordic-Baltic, Södertälje, Sweden.
authors: Johanna
authors: J
authors: Åkesson
authors: Statisticon AB, Uppsala, Sweden.
authors: Hilja
authors: H
authors: Brorsson
authors: Department of Cardiology and Department of Medicine and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: Joakim
authors: J
authors: Alfredsson
authors: Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Per A
authors: PA
authors: Albertsson
authors: Department of Internal Medicine, County Council of Jönköping, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors: Jan-Erik
authors: JE
authors: Karlsson
authors: Uppsala Clinical Research Center and Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden. Electronic address: christoph.varenhorst@ucr.uu.se.
authors: Christoph
authors: C
authors: Varenhorst
mesh_terms: D000241:Adenosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000368:Aged; D015992:Body Mass Index; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D063731:Mobile Applications; D009203:Myocardial Infarction / Q000628:therapy*; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000379:methods; D000068997:Smartphone; D016540:Smoking Cessation; D000077486:Ticagrelor
chemical_list: D058921:Purinergic P2Y Receptor Antagonists; D000077486:Ticagrelor; D000241:Adenosine