Acute Coronary Syndrome
Conditions
Keywords
Brilique treatment adherence via electronic device application (APP)
Brief summary
An electronic device application (APP) Mein Herz und ich has been developed specifically for acute coronary syndrome (ACS) patients who are prescribed to Brilique (ticagrelor) to increase adherence to treatment (medication and lifestyle changes) by a combination of reminders on medication intake, information on the importance of treatment, motivation by supportive messages, and visualisation of individual lifestyle choices' effect on cardiovascular risk. The aim of this study is to evaluate the effectiveness of this patient support tool
Detailed description
The target population are patients hospitalised with acute coronary syndrome (ACS) 18 years or older with access to an electronic device (compatible with the patient support tool), diagnosed with ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina pectoris (UA) and treated with twice daily Brilique (ticagrelor) co administered with low dose acetylsalicylic acid (ASA) according to the prescription recommendation, within 14 days following the diagnosis of the ACS event. Patients will be randomised 1:1 into an active group receiving the patient support tool under investigation via electronic device application (APP) and a control group without patient support tool. In addition, both active and control group will be randomised 1:1 to a group with or without use of a Medical Event Monitoring System (MEMS) for evaluation of treatment adherence. Patient questionnaires for evaluation of lifestyle changes, and quality of life will be administered at the beginning (Visit 1) and end (Visit 2) of the observation period. In addition, questionnaires for adherence, treatment attitudes, health care utilization and risk factors will be administered in monthly intervals This is a randomised investigation according to paragraph 23b of the German Medical Device Law examining the impact of the APP use on drug adherence, drug persistence and lifestyle changes in patients who have been prescribed Brilique (ticagrelor) as part of normal clinical practice in a 12 month timeframe after their ACS episode. The device has a European Conformity Declaration (CE-mark). In this study no investigational product will be dispensed to the study participants. Patients will need to provide their own Brilique(ticagrelor) supply from the pharmacy, as in common clinical practice. Further, assessments in this study will not be used for guiding the treatment of the patients participating in the study.
Interventions
DEVICEActive group with MEMS
Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid with APP as support tool and with MEMS
DEVICEActive group without MEMS
Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid with APP as support tool but without MEMS
DEVICEControl group with MEMS
Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid without APP as support tool but with MEMS
DEVICEControl group without MEMS
Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid without APP as support tool and without MEMS
Sponsors
AstraZeneca
Study design
Observational model
OTHER
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to 130 Years
Healthy volunteers
No
Inclusion criteria
* Provision of signed and dated patient informed consent prior to randomisation * Female or male aged 18 years or older * Acute Coronary Syndrome patients, diagnosed with ST elevation myocardial infarction, non-ST elevation myocardial infarction or unstable angina pectoris treated with Brilique (ticagrelor) prior to inclusion into this study and for whom the treating physician intends to continue prescribing twice daily Brilique (ticagrelor) co administered with low dose acetylsalicylic acid according to the prescription recommendation, within 14 days following the diagnosis of the ACS event * Ability to read, understand and write German * Patients must have access to an electronic device (compatible with the patient support tool) and willing to use it on a daily basis
Exclusion criteria
* Involvement in the planning and/or conduct of the study (applies to AstraZeneca staff and/or staff at the study site and application developer) * Participation in another clinical study with an investigational product or medical device during the last 30 days, excluding prospective/retrospective register based studies that do not require any extra visits in addition to ordinary health care * Patients on treatment with Oral Anti-Platelet drugs other than Brilique (ticagrelor) * Patients with contraindication to the use of Brilique (ticagrelor) * Patients accepted/with a plan for thoracic surgery (coronary artery bypass grafting, CABG) or any other elective surgery that cannot be postponed until after study participation * Presence of serious/severe co-morbidities in the opinion of the Investigator which may limit life expectancy (\<1 year) * For women only: patients who are currently pregnant (confirmed with positive pregnancy test) or breast feeding
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of tablets taken during the observation phase | An average of 48 weeks | Adherence to prescribed treatment according to questions 1-4 in the Brilique Adherence Questionnaire (BAQ) including a scoring system for quantification from 0-14 (i.e. one deduction for every missed Brilique (ticagrelor) tablet per week with 7 days and twice daily dosing). The BAQ will be delivered via the APP every 4 weeks. The percent of tablets taken from the last week asked for in BAQ, will be representing the last 4 weeks of Brilique use. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The percent change in key risk factors | 1 year | Key risk factors like blood pressure, laboratory parameters (if available: LDL cholesterol, HDL cholesterol, HbA1c, body weight, and BMI) |
| Percentage of tablets taken during the observation phase | An average of 48 weeks | Tablets taken measured by a Medical Event Monitoring System (MEMS) to record a time stamp for every tablets taken |
| Change in Quality of Life | 1 year | Change in Quality of Life assessed by Short Form 36 Questionnaire (SF-36v2) |
| Change in patient reported lifestyle changes | An average of one year | Lifestyle changes assessed by a Lifestyle Changes Questionnaire (LSQ) at V1 and V2 (patient reported outcome (PRO) instrument |
| Disease understanding and treatment awareness | Every four weeks during 48 weeks observational phase | Assessed according to questions 5-11 in the BAQ |
| Health care utilization | Every four weeks during the 48 weeks observational phase | Assessed on the questions 12-15 in the BAQ |
Other
| Measure | Time frame | Description |
|---|---|---|
| Patients' report on the use of alternative medication reminder or other health APPs | An average of one year | Usage of other medication reminder or health apps |
| For the active treatment group, data on the use of the patient support tool | An average of one year | The number of times the APP is used during the study through an analysis of the recorded user data |
| For the active treatment group, responses to the questions of the System Usability Scale (SUS) | An average of one year | Assessment of SUS replies at visit 2 |
| Treatment gaps according to missed tablets obtained in the subgroup of patients equipped | During 48 weeks observational phase | Missed tablets (based on MEMS) compared between randomized groups |
| Cardiovascular risk score GRACE 2.0 | During baseline | Impact of GRACE 2.0 risk score at baseline on adherence as assessed by BAQ |
Countries
Germany
Outcome results
None listed