Mobile Health Strategies for Veterans

San Francisco Veterans Affairs Medical Center

Status: Unknown

Conditions: Coronary Heart Disease

Treatments: Other: Website; Behavioral: Text Message; Behavioral: Mobile Application

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT03022669

NRI 15-455

Details and patient eligibility

About

The purpose of this study is to determine whether text messages/messaging (TM) or a mobile application (app), compared with an educational website-control provided to all Veterans, can improve adherence to antiplatelet therapy among patients following acute coronary syndrome or percutaneous coronary intervention (ACS/PCI).

Full description

Adherence to antiplatelet medications is critical to prevent life threatening complications (i.e., stent thrombosis); yet rates of non-adherence range from 21-57% by 12 months. Mobile technology through TM or mobile apps is a practical and inexpensive strategy to promote behavior change and enhance medication adherence. The three specific aims of this proposal are to: 1) determine preferences for content and frequency of TM to promote medication adherence through focus groups; 2) determine the most patient-centered app to promote adherence through a content analysis of all commercially available apps for medication adherence and focus groups centered on usability; and 3) compare adherence to antiplatelet medications in 225 Veterans post ACS/PCI through a randomized controlled trial. Participants will be randomized to either TM, mobile app, or website-control group. The focus groups will be stratified by low/high mobile phone use and sex.

Enrollment: 225 estimated patients

Sex: All

Ages: 21+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ≥ 21 years of age,
• recent ACS or PCI within 1 week
• new antiplatelet (thienopyridine) prescription
• owns a smartphone

Exclusion criteria

• cognitive impairment
• lack of English proficiency/literacy

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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225 participants in 3 patient groups

Text Message Group

Experimental group

Description:

The "TM group" will use the VA "Annie" text messaging program to remind patients to take antiplatelet medications. The content for the text messages will be determined through preliminary focus groups that will be conducted prior to the RCT.

Treatment:

Other: Website

Behavioral: Text Message

Application Group

Experimental group

Description:

The "App group" will use a mobile application to remind patients to take antiplatelet medications. The commercially available mobile app will be selected by participants through preliminary focus groups that will be conducted prior to the RCT.

Treatment:

Behavioral: Mobile Application

Other: Website

Website-Control

Experimental group

Description:

The "Website-Control group" will will be offered the American Heart Association patient education website (My Life Check - 7 Steps To Healthy Living) and will serve as an "attention-control." The website will be offered to participants in all three groups. The "7 small steps to big changes" are to manage blood pressure, control cholesterol, reduce blood sugar, get active, eat better, lose weight, and stop smoking.

Treatment:

Other: Website