Quality Measurement and Improvement Study of Surgical Coronary Revascularization： Medication Adherence （MISSION-2）

作     者：Chong-Yang Liu Jun-Zhe Du Chen-Fei Rao Heng Zhang Han-Ning Liu Yan Zhao Li-Meng Yang Xi Li Jing Li Jue Wang Hui-Shan Wang Zhi-Gang Liu Zhao-Yun Cheng Zhe Zheng Liu Chong-Yang;Du Jun-Zhe;Rao Chen-Fei;Zhang Heng;Liu Han-Ning;Zhao Yan;Yang Li-Meng;Li Xi;Li Jing;Wang Jue;Wang Hui-Shan;Liu Zhi-Gang;Cheng Zhao-Yun;Zheng Zhe

作者机构：National Clinical Research Center of Cardiovascular Diseases State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Pekinq Union Medical Colleqe Beijing 100073 China Department of Cardiovascular Surgery Fuwai Hospital National Center for Cardiovascular Diseases Chinese Academy of Medical Sciences and Peking Union Medical College Beiiinq 100073 China Department of Thoracic and Cardiovascular Surgery The First Affiliated Hospital of wenzhou Medical University Wenzhou Zhejiang 325000 China Department of Cardiovascular Surgery General Hospital of Shenyang Military Region Shenyang Liaoning 110016 China Department of Cardiovascular Surgery TEDA International Cardiovascular Hospital Peking Union Medical College and Chinese Academy of Medical Science Tianjin 300457 China Department of Cardiovascular Surgery Henan Provincial People's Hospital Fuwai Central China Cardiovascular Hospital Zhengzhou Henan 450003 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2018年第131卷第12期

页      面：1480-1489页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by the Ministry of Science and Technology of China and the Prevention and Control Project of Major Chronic Non-infection Disease during the 13th 5-year plan period the capital's funds for health improvement and research Beijing Municipal Commission of Science and Technology 

主　　题：Coronary Artery Bypass Grafting MedicationAdherence Mobile Applications Mobile Health Secondary Prevention 

摘      要：Background： Secondary preventive therapies play a key role in the prevention of adverse outcomes after coronary artery bypass grafting （CABG）. However, medication adherence alter CABG is often poor, and conventional interventions for improving adherence have limited success. With increasing penetration of smartphones, health-related smartphone applications might provide an opportunity to improve adherence. Carefully designed trials are needed to provide reliable evidence for the use of these applications in patients after CABG. Methods： The Measurement and Improvement Studies of Surgical Coronary Revascularization： Medication Adherence （MISSION-2） study is a multicenter randomized controlled trial, aiming to randomize 1000 CABG patients to the intervention or control groups in a 1 ： 1 ratio. We developed the multifaceted, patient-centered, smartphone-based Heart Health Application to encourage lnedication adherence in the intervention group through a health self management program initiated dnring hospital admission for CABG. The application integrated daily scheduled reminders to take the discharge medications, cardiac edticational materials, a dynamic dashboard to review cardiovascular risk factors and secondary prevention targets, and weekly questionnaires with interactive feedback. The primary outcome was secondary preventive medication adherence measured by the Chinese version of the 8-item Morisky Medication Adherence Scale at 6 months after randomization. Secondary outcomes included all-cause death, cardiovascular rehospitalization, and a composite of death, myocardial infarction, stroke, and repeat revascularization.Discussion： Findings will not only provide evidence regarding the feasibility and effectiveness of the described intervention for improving adherence to CABG secondary preventive therapies but also explore a model tor outpatient health self-managenlent that could be translated to various chronic diseases and widely disseminated across resource-limited settings.