Personalized Smartphone Messaging for Secondary Prevention After Percutaneous Coronary Intervention: Randomized...

Area of Science:

• Cardiology
• Digital Health
• Behavioral Science

Background:

• Cardiac rehabilitation improves outcomes post-percutaneous coronary intervention (PCI) but faces low participation due to accessibility barriers.
• Mobile health interventions offer a potential solution to enhance patient engagement and accessibility in cardiac care.

Purpose of the Study:

• To evaluate the effectiveness and user acceptability of a smartphone messaging app (AnSim) for improving cardiovascular risk factors in patients post-PCI.
• To assess the impact of personalized, tailored messages on blood pressure and other cardiovascular risk factors.

Main Methods:

• A 2-arm randomized controlled trial involving 120 patients recently undergoing PCI.
• Intervention group received AnSim app messages (6 times/week for 6 months) plus usual care; control group received usual care alone.
• Primary outcome was change in blood pressure (BP) at 6 and 9 months; secondary outcomes included lipid profiles, HbA1c, BMI, and lifestyle factors.

Main Results:

• No significant between-group differences in blood pressure were observed at 6 or 9 months.
• Exploratory analyses showed participants with higher message engagement were more likely to achieve multiple risk factor targets (69% vs 19.2%).
• The AnSim app was found to be acceptable, with 87% of users finding messages helpful and 81.4% wishing to continue use.

Conclusions:

• Low-intensity personalized messaging via AnSim did not demonstrate significant BP improvements compared to an attention-matched diary app.
• Patient engagement with the messaging app appears crucial for potential benefits, highlighting the need for optimized engagement strategies.
• AnSim offers a scalable approach to behavioral reinforcement in post-PCI care, warranting further pragmatic trials on engagement and long-term outcomes.