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Article

Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial

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Pharmacy Department, Hospital de la Santa Creu i Sant Pau, IIB Sant Pau, 08025 Barcelona, Catalonia, Spain
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Cardiology Department, Hospital de la Santa Creu i Santa Pau and CIBER de Enfermedades Cardiovasculares (CIBER-CV), 08041 Barcelona, Catalonia, Spain
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Heart Failure and Heart Transplant Unit, Cardiology Department, Hospital de la Santa Creu i Santa Pau, 08041 Barcelona, Catalonia, Spain
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Pharmacy Department, Hospital de la Santa Creu i Santa Pau, 08025 Barcelona, Catalonia, Spain
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Pharmacy Department, Hospital de la Santa Creu i Santa Pau and CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), 08025 Barcelona, Catalonia, Spain
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Author to whom correspondence should be addressed.
Academic Editors: Sara Garfield and Gaby Judah
Healthcare 2021, 9(4), 463; https://doi.org/10.3390/healthcare9040463
Received: 5 March 2021 / Revised: 5 April 2021 / Accepted: 7 April 2021 / Published: 14 April 2021
(This article belongs to the Special Issue Medication Adherence and Beliefs About Medication)
Non-adherence after heart transplantation (HTx) is a significant problem. The main objective of this study was to evaluate if a mHealth strategy is more effective than standard care in improving adherence and patients’ experience in heart transplant recipients. Methods: This was a single-center, randomized controlled trial (RCT) in adult recipients >1.5 years post-HTx. Participants were randomized to standard care (control group) or to the mHeart Strategy (intervention group). For patients randomized to the mHeart strategy, multifaceted theory-based interventions were provided during the study period to optimize therapy management using the mHeart mobile application. Patient experience regarding their medication regimens were evaluated in a face-to-face interview. Medication adherence was assessed by performing self-reported questionnaires. A composite adherence score that included the SMAQ questionnaire, the coefficient of variation of drug levels and missing visits was also reported. Results: A total of 134 HTx recipients were randomized (intervention N = 71; control N = 63). Mean follow-up was 1.6 (SD 0.6) years. Improvement in adherence from baseline was significantly higher in the intervention group versus the control group according to the SMAQ questionnaire (85% vs. 46%, OR = 6.7 (2.9; 15.8), p-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), p-value = 0.001). Patients’ experiences with their drug therapy including knowledge of their medication timing intakes (p-value = 0.019) and the drug indications or uses that they remembered (p-value = 0.003) significantly improved in the intervention versus the control group. Conclusions: In our study, the mHealth-based strategy significantly improved adherence and patient beliefs regarding their medication regimens among the HTx population. The mHeart mobile application was used as a feasible tool for providing long-term, tailor-made interventions to HTx recipients to improve the goals assessed. View Full-Text
Keywords: heart transplantation; medication therapy management; immunosuppression; treatment outcome; interdisciplinary health team; patient-reported outcome measures; behavioral sciences; treatment adherence and compliance; telemedicine; mobile health heart transplantation; medication therapy management; immunosuppression; treatment outcome; interdisciplinary health team; patient-reported outcome measures; behavioral sciences; treatment adherence and compliance; telemedicine; mobile health
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MDPI and ACS Style

Gomis-Pastor, M.; Mirabet Perez, S.; Roig Minguell, E.; Brossa Loidi, V.; Lopez Lopez, L.; Ros Abarca, S.; Galvez Tugas, E.; Mas-Malagarriga, N.; Mangues Bafalluy, M.A. Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial. Healthcare 2021, 9, 463. https://doi.org/10.3390/healthcare9040463

AMA Style

Gomis-Pastor M, Mirabet Perez S, Roig Minguell E, Brossa Loidi V, Lopez Lopez L, Ros Abarca S, Galvez Tugas E, Mas-Malagarriga N, Mangues Bafalluy MA. Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial. Healthcare. 2021; 9(4):463. https://doi.org/10.3390/healthcare9040463

Chicago/Turabian Style

Gomis-Pastor, Mar, Sonia Mirabet Perez, Eulalia Roig Minguell, Vicenç Brossa Loidi, Laura Lopez Lopez, Sandra Ros Abarca, Elisabeth Galvez Tugas, Núria Mas-Malagarriga, and Mª A. Mangues Bafalluy. 2021. "Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial" Healthcare 9, no. 4: 463. https://doi.org/10.3390/healthcare9040463

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