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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
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active APP with MEMS | ACS patients 18 years or older with access to an electronic device (compatible with the patient support tool), diagnosed with STEMI, NSTEMI or UA treated with twice daily Brilique(ticagrelor) co administered with low dose acetylsalicylic acid according to the prescription recommendation using active APP with MEMS |
| |
| Active APP without MEMs | ACS patients 18 years or older with access to an electronic device (compatible with the patient support tool), diagnosed with STEMI, NSTEMI or UA treated with twice daily Brilique(ticagrelor) co administered with low dose acetylsalicylic acid according to the prescription recommendation using active APP without MEMS |
| |
| Control APP with MEMS | ACS patients 18 years or older with access to an electronic device (compatible with the patient support tool), diagnosed with STEMI, NSTEMI or UA treated with twice daily Brilique(ticagrelor) co administered with low dose acetylsalicylic acid according to the prescription recommendation using control APP with MEMS |
| |
| Control APP without MEMS | ACS patients 18 years or older with access to an electronic device (compatible with the patient support tool), diagnosed with STEMI, NSTEMI or UA treated with twice daily Brilique(ticagrelor) co administered with low dose acetylsalicylic acid according to the prescription recommendation using control APP without MEMS |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Active group with MEMS | Device | Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid with APP as support tool and with MEMS |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of tablets taken during the observation phase | 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. | An average of 48 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of tablets taken during the observation phase | Tablets taken measured by a Medical Event Monitoring System (MEMS) to record a time stamp for every tablets taken | An average of 48 weeks |
| The percent change in key risk factors |
| Measure | Description | Time Frame |
|---|---|---|
| Cardiovascular risk score GRACE 2.0 | Impact of GRACE 2.0 risk score at baseline on adherence as assessed by BAQ | During baseline |
| Treatment gaps according to missed tablets obtained in the subgroup of patients equipped |
Inclusion Criteria:
Exclusion Criteria:
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The target population are acute coronary syndrome (ACS) patients 18 years or older with access to an electronic device (compatible with the patient support tool), diagnosed with ST elevation myocardial infarction, non-ST elevation myocardial infarction or unstable angina pectoris treated with 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.
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| Name | Affiliation | Role |
|---|---|---|
| Florian Krackhardt, MD | Charite University, Berlin, Germany | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Research Site | Bad Berka | 99437 | Germany | |||
| Research Site |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35441926 | Derived | Krackhardt F, Jornten-Karlsson M, Waliszewski M, Knutsson M, Niklasson A, Appel KF, Degenhardt R, Ghanem A, Kohler T, Ohlow MA, Tschope C, Theres H, Vom Dahl J, Karlson BW, Maier LS. Results from the "Me & My Heart" (eMocial) Study: a Randomized Evaluation of a New Smartphone-Based Support Tool to Increase Therapy Adherence of Patients with Acute Coronary Syndrome. Cardiovasc Drugs Ther. 2023 Aug;37(4):729-741. doi: 10.1007/s10557-022-07331-1. Epub 2022 Apr 20. | |
| 31490566 |
| Label | URL |
|---|---|
| D5130C00161 CSR Synopsis Redacted | View source |
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| Active group without MEMS | Device | Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid with APP as support tool but without MEMS |
|
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| Control group with MEMS | Device | Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid without APP as support tool but with MEMS |
|
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| Control group without MEMS | Device | Patients treated with twice daily Brilique (ticagrelor) co administered with low dose of acetylsalicylic acid without APP as support tool and without MEMS |
|
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Key risk factors like blood pressure, laboratory parameters (if available: LDL cholesterol, HDL cholesterol, HbA1c, body weight, and BMI)
| 1 year |
| Change in Quality of Life | Change in Quality of Life assessed by Short Form 36 Questionnaire (SF-36v2) | 1 year |
| Change in patient reported lifestyle changes | Lifestyle changes assessed by a Lifestyle Changes Questionnaire (LSQ) at V1 and V2 (patient reported outcome (PRO) instrument | An average of one year |
| Disease understanding and treatment awareness | Assessed according to questions 5-11 in the BAQ | Every four weeks during 48 weeks observational phase |
| Health care utilization | Assessed on the questions 12-15 in the BAQ | Every four weeks during the 48 weeks observational phase |
Missed tablets (based on MEMS) compared between randomized groups
| During 48 weeks observational phase |
| Patients' report on the use of alternative medication reminder or other health APPs | Usage of other medication reminder or health apps | An average of one year |
| For the active treatment group, data on the use of the patient support tool | The number of times the APP is used during the study through an analysis of the recorded user data | An average of one year |
| For the active treatment group, responses to the questions of the System Usability Scale (SUS) | Assessment of SUS replies at visit 2 | An average of one year |
| Bad Bevensen |
| 29549 |
| Germany |
| Research Site | Bad Krozingen | 79189 | Germany |
| Research Site | Barby | 39249 | Germany |
| Research Site | Berlin | 12203 | Germany |
| Research Site | Berlin | D-13353 | Germany |
| Research Site | Bernau | 16321 | Germany |
| Research Site | Chemnitz | 09116 | Germany |
| Research Site | Coburg | 96450 | Germany |
| Research Site | Düsseldorf | 40217 | Germany |
| Research Site | Erkrath | 40699 | Germany |
| Research Site | Essen | 45219 | Germany |
| Research Site | Frankfurt | 65929 | Germany |
| Research Site | Gelsenkirchen | 45891 | Germany |
| Research Site | Hamburg | 20099 | Germany |
| Research Site | Heidelberg | 69120 | Germany |
| Research Site | Kassel | 34117 | Germany |
| Research Site | Kassel | 34121 | Germany |
| Research Site | Kiel | 24105 | Germany |
| Research Site | Kleve | 47533 | Germany |
| Research Site | Lübeck | 23560 | Germany |
| Research Site | Mainz | 55131 | Germany |
| Research Site | Mönchengladbach | 41063 | Germany |
| Research Site | Münster | 48149 | Germany |
| Research Site | Oldenburg | 26133 | Germany |
| Research Site | Regensburg | 93053 | Germany |
| Research Site | Rostock | 18057 | Germany |
| Research Site | Rotenburg (Wümme) | 36199 | Germany |
| Research Site | Siegen | 57072 | Germany |
| Research Site | Tegel | 13507 | Germany |
| Research Site | Wuppertal | 42117 | Germany |
| Derived |
| Krackhardt F, Maier LS, Appel KF, Kohler T, Ghanem A, Tschoepe C, Dahl JV, Degenhardt R, Niklasson A, Ahlqvist M, Waliszewski MW, Jornten-Karlsson M. Design and rationale for the "Me & My Heart" (eMocial) study: A randomized evaluation of a new smartphone-based support tool to increase therapy adherence of patients with acute coronary syndrome. Clin Cardiol. 2019 Nov;42(11):1054-1062. doi: 10.1002/clc.23254. Epub 2019 Sep 6. |
| ID | Term |
|---|---|
| D054058 | Acute Coronary Syndrome |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D055617 | Micro-Electrical-Mechanical Systems |
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D055615 | Electrical Equipment and Supplies |
| D004864 | Equipment and Supplies |
| D008420 | Manufactured Materials |
| D013676 | Technology, Industry, and Agriculture |
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |
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