Increasing cardiovascular medication adherence: A medical research council complex mhealth intervention mixed‐methods feasibility study to inform global practice

Khonsari, Sahar; Chandler, Colin; Parker, Richard; Holloway, Aisha

Abstract

Aims
To evaluate a mHealth intervention to increase medication adherence among Iranian coronary heart disease patients.

Design
Quantitative-dominant mixed-methods study.

Data Source
Iranian coronary heart disease patients’ responses and most recent clinical documents as well as responses from Iranian cardiac nurses who participated in this study.

Methods
The study was conducted between September 2015–April 2016 drawing on the Medical Research Council's Framework. Phase one comprised of a patients’ survey and focus groups with cardiac nurses. The automated short message service reminder was piloted in phase two. We recruited 78 patients and randomized to receive either 12-week daily reminders or usual care. The primary outcome was the effect on medication adherence; secondary outcomes were self-efficacy, ejection fraction, functional capacity, readmission rate and quality of life.

Results
Feasibility was evidenced by high ownership of mobile phones and high interest in receiving reminders. Participants in the intervention group showed significantly higher medication adherence compared with the control group.

Conclusion
The mHealth intervention was well accepted and feasible with early evidence of effectiveness that needs to be confirmed in a fully powered future randomized clinical trial.

• Journal Article Type: Article
• Acceptance Date: Jun 8, 2020
• Online Publication Date: Aug 5, 2020
• Publication Date: 2020-10
• Deposit Date: Jan 25, 2024
• Journal: Journal of Advanced Nursing
• Print ISSN: 0309-2402
• Electronic ISSN: 1365-2648
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 76
• Issue: 10
• Pages: 2670-2684
• DOI: https://doi.org/10.1111/jan.14465
• Keywords: coronary heart disease, Iran, medication adherence, mHealth, nurses, secondary prevention, text messaging
• Public URL: http://researchrepository.napier.ac.uk/Output/3487826