Examining the potential for information and communication technology to support patients with cardiovascular disease

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Acute coronary syndrome
Cardiovascular disease
Text messaging
Mobile health

The overall goal of this work was to investigate the potential of information and communication technology (ICT) to support patients with cardiovascular disease (CVD). There were two specific aims: (1) to determine access to and willingness to use technology for health-related information in patients with CVD; and (2) to develop and pilot test a text-messaging intervention to support patients with acute coronary syndrome (ACS) following discharge from the hospital. The first aim was done with a cross-sectional survey (n=169). ICT ownership was common, as 98% of participants owned at least one ICT device. Computers were the most commonly owned device (88%), the device most commonly used for health information (74% of computer owners), and the device participants had the most interest in using for health information (72% of computer owners). Participants with lower incomes and education levels were less interested in receiving health information on at least one of their devices. The second aim was done with a mixed-methods, assessor-blinded, pilot randomized controlled trial (n=76). An advisory committee composed of patients, researchers, and clinicians developed 48 one-way text messages to send over 60 days to patients with ACS. There were no statistically significant differences between the intervention and usual care groups for self-management domains, medication adherence, health-related quality of life, self-efficacy, and healthcare resource use except for one self-efficacy domain. The study protocol was feasible, except recruitment took longer than anticipated. Ninety-three percent reported they were satisfied with the text messages. In the semi-structured interviews, many participants reported the program made them feel normal, perceived the program to be a source of social support, reinforced they were on the right track, and reminded them of their condition. However, some participants felt they did not need the messages, wished for a more tailored experience, or did not change their behaviours as a result. Learnings from the pilot study should be addressed prior to proceeding to a larger trial. Overall, these two studies indicate that ICT can be acceptable to patients with CVD. Further work needs to be done to determine how to best use ICT to support patients.

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This thesis may be printed or downloaded for non-commercial research and scholarly purposes. Copyright remains with the author.
Scott Lear
Science: Department of Biomedical Physiology and Kinesiology
Thesis type: 
(Thesis) Ph.D.