Increasing cardiovascular medication adherence: A Medical Research Council complex mHealth intervention mixed-methods feasibility study to inform global practice

Aims:
To evaluate a mHealth intervention to increase medication adherence among Iranian coronary heart disease patients.

Design:
Quantitative-dominant mixed-methods study

Data Source:
Iranian coronary heart disease patients’ responses and most recent clinical documents as well as responses from Iranian cardiac nurses who participated in this study.

Methods:
The study was conducted between September 2015 and April 2016 drawing upon the Medical Research Council’s Framework. Phase one comprised of a patients’ survey and focus groups with cardiac nurses. The automated short message service reminder was piloted in phase two. We recruited 78 patients and randomised to receive either 12-week daily reminders or usual care. The primary outcome was the effect on medication adherence; secondary outcomes were self-efficacy, ejection fraction, functional capacity, readmission rate and quality of life.

Results:
Feasibility was evidenced by high ownership of mobile phones and high interest in receiving reminders. Participants in the intervention group showed significantly higher medication adherence compared to the control group.

Conclusion:
The mHealth intervention was well accepted and feasible with early evidence of effectiveness that needs to be confirmed in a fully powered future randomised clinical trial.