Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 30, 2020
Date Accepted: Apr 3, 2021
Effects of the Interactive Web-Based Video “Mon Coeur, Mon BASIC” on Drug Adherence of Patients with Myocardial Infarction: A Randomized Study
ABSTRACT
Background:
Secondary prevention strategies after acute coronary syndrome (ACS) presentation with the use of drug combinations are essential to reduce the recurrence of cardiovascular events. However, the lack of drug adherence is known to be common in this population, and to be related to treatment failure. To improve drug adherence, we developed the “Mon Coeur, Mon BASIC” web-based interactive video to inform patients about ACS and their drug treatments.
Objective:
To assess the impact of the web-based video on drug adherence.
Methods:
This randomized study was conducted with consecutive patients admitted to Lausanne University Hospital for ACS. We randomized patients to an intervention group, which had access to the video, and a control group receiving usual care. The primary outcome was the difference in drug adherence, assessed with the Adherence to Refills and Medication Scale [ARMS; nine multiple-choice questions, scores ranging from 12 (perfect adherence) to 48 (lack of adherence)], between groups at 1, 3, and 6 months. We assessed the difference in ARMS score between both groups with Wilcoxon rank sum test. Secondary outcomes were differences in knowledge and readmissions and emergency room visits between groups, and patients’ satisfaction with the video.
Results:
Sixty patients were included at baseline. The median age of the participants was 59 (IQR 49–69) and 85% were male. At 1 month, 51 patients participated in the follow up, 50 patients participated at 3 months, and 47 patients participated at 6 months. The mean ARMS scores at 1 and 6 months did not differ between the intervention and control groups (13.24 and 13.15, 13.52 and 13.68, respectively). At 3 months, this score was significantly lower in the intervention group than in the control group (12.54 vs. 13.75, P = .034). We observed significant increases in knowledge from baseline to 1 and 3 months, but not to 6 months, in the intervention group. Readmissions and emergency room visits have been very rare and the proportion was not different among groups. Patients in the intervention group were highly satisfied with the video.
Conclusions:
The “Mon Coeur, Mon BASIC” web-based interactive video improved patients’ knowledge and seemed to have an impact on drug adherence. These results are encouraging, and the video will be offered to all patients admitted to our hospital with ACS. Clinical Trial: ClinicalTrials.gov NCT03949608; https://clinicaltrials.gov/ct2/show/NCT03949608
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