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Effect of an avatar-based discharge education application on knowledge and behaviour in people after acute coronary
Tiffany Ellis1,2, Sonia Cheng2, Robert Zecchin3
1Department of Physiotherapy, Westmead Hospital, Sydney, New South Wales, Australia tiffany.sorial@health.nsw.gov.au.
Insights
An avatar-based app may improve secondary prevention knowledge for acute coronary syndrome (ACS) patients. This study tested an app delivering cardiac recovery education, aiming to enhance patient understanding and outcomes after hospital discharge.
Area of Science:
- Cardiology
- Digital Health
- Patient Education
Background:
- Recurrent acute coronary syndrome (ACS) events are common, increasing healthcare burden.
- Secondary prevention education and discharge planning are crucial but often limited by clinician time and patient engagement.
- Novel digital health solutions are needed to improve patient adherence to secondary prevention strategies.
Purpose of the Study:
- To evaluate the effectiveness of an avatar-based education app in improving secondary prevention knowledge for individuals with ACS.
- To assess the app's impact on quality of life, symptom response, readmissions, mortality, and modifiable cardiac risk factors.
Main Methods:
- A prospective, randomized controlled trial with 72 participants and 3-month follow-up.
- Intervention group received usual care plus an avatar-based app with six interactive education modules.
- Primary outcome: knowledge of coronary heart disease (CHD) assessed by the Coronary Artery Disease Education Questionnaire II.
Main Results:
- The study protocol is designed to compare knowledge acquisition between the intervention and control groups.
- Secondary outcomes will assess improvements in quality of life and reduction in cardiac events.
- App engagement will be objectively measured to understand user interaction.
Conclusions:
- Avatar-based digital health interventions offer a promising avenue for delivering scalable and engaging secondary prevention education.
- This study will provide evidence on the utility of such apps in managing patients with ACS.
- Findings will inform the integration of digital tools into cardiac rehabilitation programs.
Introduction:
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.
Methods And Analysis:
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.
Ethics And Dissemination:
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.
Trial Registration Number:
Australian New Zealand Clinical Trials Registry (ACTRN12622001436763).
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