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Journal of Medical Engineering & Technology Volume 40, 2016 - Issue 7-8: E-Health in Low to Middle Income Countries
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Innovation

Development of a mobile phone-based intervention to improve adherence to secondary prevention of coronary heart disease in China

Shu ChenGlobal Health Research Center, Duke Kunshan University, Kunshan, China;
,
Enying GongGlobal Health Research Center, Duke Kunshan University, Kunshan, China;
,
Dhruv S. KaziDivision of Medicine (Cardiology), University of California San Francisco, San Francisco, CA, USA; ;Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA;
,
Ann B. GatesExercise Works Ltd, Derby, United Kingdom;
,
Kamilu Musa KarayeDepartment of Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria;
,
Nicolas GirerdINSERM, Centre d’ Investigations Cliniques 9501, Université de Lorraine, CHU de Nancy, Institut Lorrain du Cœur et des Vaisseaux, Nancy, France; ;INI-CRCT (Cardiovascular and Renal Clinical Trialists) FCRIN Network, Nancy, France;
,
Rong BaiNational Clinical Research Center for Cardiovascular Diseases, Beijing, China; ;Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China;
,
Khalid F. AlHabibCollege of Medicine, King Saud University, Riyadh, Saudi Arabia;
,
Chaoyun LiGlobal Health Research Center, Duke Kunshan University, Kunshan, China;
,
Kelly SunDegroote School of Medicine, McMaster University, Hamilton, Ontario, Canada;
,
Louisa HongDegroote School of Medicine, McMaster University, Hamilton, Ontario, Canada;
,
Hua FuSchool of Public Health, Fudan University, Shanghai, China;
,
Weixia PengDepartment of Cardiology, Hainan Nongken General Hospital, Haikou, China;
,
Xianxia LiuMcMaster University/Hamilton Health Sciences/Population Health Research Institute, Hamilton, Ontario, Canada;
,
Lei ChenMcMaster University/Hamilton Health Sciences/Population Health Research Institute, Hamilton, Ontario, Canada;
,
J.-D. SchwalmDuke Global Health Institute, Duke University, Durham, NC, USA
&
Lijing L. YanGlobal Health Research Center, Duke Kunshan University, Kunshan, China; ;Duke Global Health Institute, Duke University, Durham, NC, USACorrespondence[email protected] [email protected]
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Pages 372-382 | Received 29 Feb 2016, Accepted 25 May 2016, Published online: 12 Aug 2016
 
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Abstract

Coronary heart disease (CHD) is a major disease burden globally and in China, but secondary prevention among CHD patients remains insufficient. Mobile health (mHealth) technology holds promise for improving secondary prevention but few previous studies included both provider-facing and patient-directed measures. We conducted a physician needs assessment survey (n = 59), physician interviews (n = 6), one focus group and a short cellphone message validation survey (n = 14) in Shanghai and Hainan, China. Based on these results, we developed a multifaceted mHealth intervention that includes: (1) a provider-facing bilingual mobile app guiding prescription of evidence-based medications for secondary prevention and (2) a patient-directed short messaging system automatically sending reminders to patients regarding medication adherence and lifestyle changes (4–5 messages per week for 12 weeks). This combined intervention has the potential to improve secondary prevention of CHD and to be adapted to other countries and healthcare conditions.

Acknowledgements

We would like to give our sincere appreciation to our academic partners including McMaster University, Canada that was involved in the app and message development stage from the very beginning and School of Public Health, Fudan University that was in charge of the needs assessment in Shanghai. We also thank the Department of Cardiology, Hainan Nongken General Hospital, Haikou, Hainan Province for the support of needs assessment work in Hainan. In addition, we acknowledge the contribution of Mr. Yuliang Wang from School of Public Health, Fudan University, Dr. Ye Sun from Hainan Nongken General Hospital for their research assistance and coordination.

Disclosure statement

The authors declare that they have no conflict of interests.

Funding

We would like to thank World Heart Federation and Duke Kunshan University for their funding support.

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