背景:冠心病(CHD)仍然是澳大利亚的主要死亡原因,幸存者中重复事件的残余风险很高。二级预防治疗对于降低死亡和其他主要不良心脏事件的风险至关重要。澳大利亚国家心脏基金会制定了一项面向消费者的支持计划,名为“我的心”,我的生活(MHML)来解决澳大利亚冠心病二级预防方面的差距。MHML试点计划为患者及其护理人员提供建议和支持,并在2019年11月至2020年6月的8个月内进行。
目的:本研究旨在描述和检查一项名为MHML的新型多模态二级冠心病预防试点项目的实施情况。是通过小册子递送的,短信,电子邮件,和电话。
方法:本试点研究由混合方法评估组成,涉及对参与者(患者和护理人员)和卫生专业人员的调查,深入采访,和数字通信(SMS短信,电子直邮,和通话记录分析)。这项研究是在2019年11月至2020年6月期间,通过澳大利亚国家心脏基金会网页,在38家澳大利亚医院的18岁以上急性冠状动脉综合征或心绞痛患者及其护理人员中进行的。主要成果措施是达成的,可访问性,可行性,障碍,以及实施该计划的推动者。
结果:在1004名参与者中(838名患者和164名护理人员;2名失踪),60.9%(608/1001)为男性,50.7%(491/967)的患者年龄在45至64岁之间,27.4%(276/1004)来自贫困地区,2.5%(24/946)来自原住民或托雷斯海峡岛民背景,16.9%(170/1004)将英语作为第二语言。参与者(患者及其护理人员)和卫生专业人员报告对MHML计划的满意度很高(55/62,88.7%和33/38,87%,分别)。在接受调查的62名参与者中,88%(55/62)使用短信服务,并报告了非常高的满意度。大约94%(58/62)和89%(55/62)的参与者分别对快速指南手册1和2感到满意;79%(49/62)对每月电子邮件旅程感到满意,71%(44/62)对求助热线感到满意。大多数参与者报告说,MHML计划改善了预防行为,也就是说,其中73%(45/62)报告说他们保持了增加的身体活动,而84%(52/62)报告说他们即使在MHML计划之后也保持了健康的饮食。
结论:我们的试点研究结果表明,多式联运支持计划,包括数字,打印,电话,和基于网络的媒体,对于冠心病的二级预防是有用的,并且可能是为急性冠脉综合征幸存者提供定制规模二级预防支持的潜在手段.
BACKGROUND: Coronary heart disease (CHD) remains the leading cause of death in Australia, with a high residual risk of repeat events in survivors. Secondary prevention therapy is crucial for reducing the risk of both death and other major adverse cardiac events. The National Heart Foundation of Australia has developed a consumer-facing support program called My Heart, My Life (MHML) to address the gap in the secondary prevention of CHD in Australia. The MHML pilot program supplies advice and support for both patients and their caregivers, and it was conducted over 8 months from November 2019 to June 2020.
OBJECTIVE: This study aims to describe and examine the implementation of a novel multimodality secondary CHD prevention pilot program called MHML, which was delivered through booklets, text messages, emails, and telephone calls.
METHODS: This pilot study consists of a mixed methods evaluation involving surveys of participants (patients and caregivers) and health professionals, in-depth interviews, and digital communication (SMS text message, electronic direct mail, and call record analytics). This study was performed in people older than 18 years with acute coronary syndrome or angina and their caregivers in 38 Australian hospitals from November 2019 to June 2020 through the National Heart Foundation of Australia web page. The main outcome measures were reach, accessibility, feasibility, barriers, and enablers to implementation of this program.
RESULTS: Of the 1004 participants (838 patients and 164 caregivers; 2 missing), 60.9% (608/1001) were males, 50.7% (491/967) were aged between 45 and 64 years, 27.4% (276/1004) were from disadvantaged areas, 2.5% (24/946) were from Aboriginal or Torres Strait Islander background, and 16.9% (170/1004) reported English as their second language. The participants (patients and their caregivers) and health professionals reported high satisfaction with the MHML program (55/62, 88.7% and 33/38, 87%, respectively). Of the 62 participants who took the survey, 88% (55/62) used the text messaging service and reported a very high level of satisfaction. Approximately 94% (58/62) and 89% (55/62) of the participants were satisfied with the quick guide booklets 1 and 2, respectively; 79% (49/62) were satisfied with the monthly email journey and 71% (44/62) were satisfied with the helpline calls. Most participants reported that the MHML program improved preventive behaviors, that is, 73% (45/62) of them reported that they maintained increased physical activity and 84% (52/62) reported that they maintained a healthy diet even after the MHML program.
CONCLUSIONS: The findings of our pilot study suggest that a multimodal support program, including digital, print, phone, and web-based media, for the secondary prevention of CHD is useful and could be a potential means of providing customized at-scale secondary prevention support for survivors of acute coronary syndrome.