在急性冠状动脉综合征后改善药物坚持和二次预防的短信:TEXTMEDS随机临床试验
Clara K Chow1,2, Harry Klimis1,2, Aravinda Thiagalingam1,2
1Westmead Applied Research Institute (C.K.C., H.K., A.T., A.V.H., A.R.), University of Sydney, Australia.
Circulation
|May 9, 2022
概括
短信干预没有改善急性冠状动脉综合征后的药物坚持. 然而,TEXTMEDS计划对生活方式的风险因素产生了微小的积极影响,这表明可能有更广泛的心血管健康益处.
科学领域:
- 心脏病学
- 数字健康
- 公共卫生
背景情况:
- 急性冠状动脉综合征 (ACS) 需要二次预防策略来减少复发事件.
- 药物不服药是ACS后有效的二次预防的重要障碍.
- 数字健康干预,如短信,提供了一个可扩展的方法来支持患者的自我管理.
研究的目的:
- 评估基于短信的干预措施 (TEXTMEDS) 在改善患者的药物坚持和二次预防结果的有效性.
- 评估激励和支持性短信对坚持心脏保护药物和改变生活方式的影响.
主要方法:
- 一个单盲多中心随机对照试验,涉及1424名ACS后患者.
- 干预组接受了通常的护理以及每周的双向沟通激励性短信.
- 对照组接受了通常的护理. 主要结局是6个月和12个月的自我报告的药物坚持 (> 80% 到 5 种药物).
主要成果:
- 在干预组和对照组之间没有观察到药物坚持的显著差异 (RR 0. 93; P=0. 15).
- 坚持个别药物,血压,LDL胆固醇,吸烟状态和定期炼没有显著的群体差异.
- 在每日蔬菜摄入量 (≥5份) 和每日水果摄入量 (≥2份) 中,观察到有利于干预组的小但具有统计意义的改善.
结论:
- 基于短信的心脏教育和支持没有改善患者在ACS后的药物坚持.
- TEXTMEDS干预措施对特定的生活方式风险因素产生了适度的积极影响,表明了更广泛的健康行为变化潜力.
- 进一步的研究可能会探索优化的数字策略,在心血管二次预防中改善药物坚持.
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