Randomized, Single Center Study About the Impact of an E-learning Dedicated to Myocardial Infarction Patient
調査の概要
詳細な説明
Cardiovascular disease is a major cause of morbi-mortality in industrialized countries. Risk of recurrence after appropriate treatment is particularly frequent in patients with inadequate observance. Secondary prevention is therefore essential to reduce the morbi-mortality of high-risk cardiovascular patients. Risk factor control and lifestyle interventions are important for these high-risk patients to reduce the overall incidence of cardiac disease. To treat these risk factors and for secondary prevention after a cardiovascular event, some medications have been shown to be efficient and European guidelines have been written to enhance evidence-based medicine prescriptions for STEMI and NSTEMI. Despite this, concerns have been postulated about patient's self-adherence to these treatments. A study has shown a long-term adherence to medications of 71% for Aspirin, 46% for β-blockers and 44% for Lipid-lowering therapy for Coronary Artery Disease (CAD) patients. Non-adherence has been associated with increased morbi-mortality in this population.
Therefore, a variety of interventions was identified to enhance patient adherence to medication in the cardiovascular field. These strategies included:
- Informational intervention (mailed information)
- Sending reminder postcards, illustrated daily medication schedule distribution
- Counseling on the importance of adherence to their cardiovascular medication and review of each medication during the hospital stay
- Clinical pharmacist intervention with medication reconciliation, medication education, facilitation of the delivery of discharge medications, and post-discharge telephone call within 48-72h These interventions showed an impact on long-term medication adherence and health literacy, which could lead to an improvement of the morbi-mortality of cardiovascular risk patients.
In a previous study conducted at the University hospital of Lausanne, the investigators showed a very high prescription rate of guidelines-recommended medications for patients involved in the CHUV STEMI (ST-Elevation Myocardial Infarction) network. Therefore, the next step to reduce the morbi-mortality of high-risk cardiovascular patients is to enhance patient adherence to the cardiovascular drug regimen. Patient education is known as an effective process to enhance drug adherence. Unfortunately, patient education is difficult to implement because of it costs and for the time needed to educate the patient. The investigator's aim at testing a new approach using an e-learning tool for patient education purpose. The e-learning will be interactive and easy to use. It will inform the patient about his heart disease (acute coronary syndrome) and about his medications in a short time.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
-
-
-
Lausanne、スイス、1011
- Centre Hsopitalier Universitaire Vaudois
-
-
参加基準
適格基準
就学可能な年齢
- 子
- 大人
- 高齢者
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Admission for acute coronary syndrome (ACS) in the cardiology unit of the University hospital of Lausanne (NSTEMI or STEMI)
- Have a percutaneous coronary intervention (PCI) as therapeutic strategy
- Patients going through an elective PCI for a second vessel after having suffered from an acute coronary syndrome in the previous month
- > 18 years
- Total discernment capacity and French speaking
- Have a digital tablet, a smartphone or a computer to have the possibility to watch the e-learning at home
- Informed Consent as documented by signature (Appendix Informed Consent Form)
Exclusion Criteria:
- Inability to follow the procedures of the study, e.g. due to language problems, psychological disorders, dementia, etc. of the participant,
- Refugee claimants, homeless persons, prisoners by impossibility to contact them after discharge
- Patients with communication problems
- Life expectancy < 6 months caused by other co-morbidities
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：支持療法
- 割り当て：ランダム化
- 介入モデル：順次割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
介入なし：コントロール
普段のお手入れ
|
|
|
実験的：BASIC
"mon cœur, mon BASIC" video viewing and installation in the own smartphone or tablet of the patient
|
The intervention consists of the presentation and installation of an internet tool to educate the patient about his heart condition and about his medications in addition to usual care.
The tool is an interactive web-hosting video called "Mon Coeur, mon BASIC" adaptable to smartphones and tablets.
The total length of the video is around 15 minutes.
The e-learning is interactive because of the possibility to click in the video to have more details about a particular point.
The tool includes a part about the heart and particularly about the ACS (physiopathology, diagnosis, coronarography, angioplasty).
A second part includes an education about the medications prescribed.
The patient will select the medication being prescribed and receive information about it.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
ARMS (Adherence to Refill and Medication Score) score difference
時間枠：1,3 and 6 months
|
Adherence to Refill and Medication Score is a self-reported questionnaire with 12-items.
8 items assess adherence to taking medications, and 4 items assess the refill to medication.
The results can vary from 12 (most adherent) to 48 (less adherent).
The ARMS questionnaire will be assessed after 1 month, 3 months and 6 months.
We will assess the difference in the mean ARMS score between control group and intervention group at these 3 timepoints.
|
1,3 and 6 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Knowledge about the disease and medications
時間枠：at time of inclusion, 1 day after inclusion for control group and after the viewing of the video for the intervention group, 1 month, 3 months and 6 months
|
Difference in a knowledge score assessed with a 9 multiple choice questions about the disease (examples: what is a coronary artery?
What happens during an acute myocardial infarction?
Which medication is used to reduce cholesterol level?).
The maximum score is 9 and the minimum is 0. The mean score will be tested between intervention and control group.
The score variation will be assessed during time after ACS.
|
at time of inclusion, 1 day after inclusion for control group and after the viewing of the video for the intervention group, 1 month, 3 months and 6 months
|
|
LDL-c measurement
時間枠：3 months
|
Difference in LDL-c measurements from discharge to 3 months
|
3 months
|
|
BMI
時間枠：6 months
|
Difference in BMI from discharge to 6 months
|
6 months
|
|
Target Blood Pressure
時間枠：6 months
|
proportion of patients being in the target blood pressure measurements at 6 months
|
6 months
|
|
composite endpoint of readmission, reinfarction or emergency visit
時間枠：6 months
|
Readmissions, reinfarction and emergency visit will be assessed with a questionnaire at 6 months.
We will assess if there is a difference between intervention and control group.
|
6 months
|
協力者と研究者
捜査官
- 主任研究者：Christel Bruggmann, PharmD、Centre Hospitalier Universitaire Vaudois (CHUV)
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。