JMIR Publications

ABSTRACT

Background:

Coronary heart disease is one of the main causes of mortality worldwide. Secondary prevention is essential as it reduces the risk of further coronary events. Mobile health (mHealth) technology could become a useful tool to improve the lifestyles of people that have experienced a coronary event.

Objective:

The aim of this study was to evaluate by means of a clinical trial the effect of a mobile health (mHealth) intervention on people with heart disease subjected to a percutaneous coronary intervention in terms of the following variables: improvements in lifestyle regarding diet, physical activity and smoking; level of knowledge of a healthy lifestyle and the control of CVRF; and therapeutic adherence and quality of life.

Methods:

This is a randomized controlled clinical trial with a parallel group design. The study included patients with coronary artery disease that had undergone a percutaneous coronary intervention and were randomly assigned (1:1) either to an intervention involving an online smartphone application that established aims and the self-control of lifestyle and cardiovascular risk factors (m-health group), or to standard health care (control group). Both groups were assessed after nine months. The primary outcome variables were: adherence to the Mediterranean diet, frequency food was consumed, physical activity performed, smoking, level of knowledge of healthy lifestyles and the control of cardiovascular risk factors (CVRF), adherence to treatment, quality of life, well-being and satisfaction. Clinical trial number in ClinicalTrials NCT04118504.

Results:

The study analysed 128 patients, 67 in the mHealth group and 61 in the control group; most were male (71.9%), with a mean age of 59.49±8.97. Significant improvements were observed in the mHealth group compared with the control group regarding adherence to the Mediterranean diet (11.83±1.74 points vs. 10.14±2.02 points, p<0.000), time spent each week doing physical activity (619.14±318.21 min/week vs. 471.70±261.43 min/week, p=0.007), giving up smoking (75.8 vs. 42.3%, p= 0.015), level of knowledge of a healthy lifestyle and the control of CVRF (118.70±2.65 points vs. 111.25±9.05 points, p=0.000) and the physical component of quality of life SF-12 (45.80±10.79 points vs. 41.40±10.78 points, p=0.029). Overall satisfaction was higher in the mHealth group (48.22±3.89 vs. 46.00±4.82 points, p=0.002) and scores for satisfaction with and usability of the application were high (44.38 ±6.18 out of 50 points and 95.22±7.37 out of 100).

Conclusions:

Interventions using mHealth technology are effective in people with coronary artery disease to improve their lifestyle in terms of adherence to the Mediterranean diet, doing physical activity and, giving up smoking. The mHealth application help patients to acquire knowledge about healthy lifestyles and controlling CVRF, improving their quality of life and satisfaction with the health care received. Clinical Trial: Clinical trial number in ClinicalTrials NCT04118504.